Organization Active NPI

Endoscopy Center of Southeast Texas LP

  • Ambulatory Surgical Clinic/Center
  • Beaumont, TX
National Provider Identifier
1295714301
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
008331 Issued in TX
Legal business name
ENDOSCOPY CENTER OF SOUTHEAST TEXAS LP
Doing business as
Endoscopy Center of Southeast Texas
Practice address
950 N 14TH St
Suite 200
Beaumont, TX 77702-1101
Phone
(409) 833-5555
Fax
(409) 833-9911
NPI assigned
Jan 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Jeffrey E Snodgrass
Title
President
Phone
(615) 665-1283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 008331 TX Primary

Addresses

Primary practice location

950 N 14TH St
Suite 200
Beaumont, TX 77702-1101

Mailing address

1A Burton Hills Blvd
Nashville, TN 37215-6187
Phone (615) 665-1283

Other identifiers 2

IdentifierTypeStateIssuer
107758801MedicaidTX
1186180MedicaidLA

Other names 1

  • Endoscopy Center of Southeast Texas Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060220000518 TX Part B Supplier - Ambulatory Surgical Center 6800801341 Practice locations: Beaumont, TX

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Endoscopy Center of Southeast Texas LPCCN 45C0001170
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0915905Endoscopy Center of Southeast Texas950 North 14TH Street Suite 200, Beaumont, TX 77702Certificate of waiverJun 10, 2028

National Provider Directory

National Provider Directory

Locations

950 N 14th St
Ste 200
Beaumont, TX 77702
Phone (409) 833-5555

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655942400000",
    "number": "1295714301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1A BURTON HILLS BLVD",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156187",
            "telephone_number": "615-665-1283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 N 14TH ST",
            "address_2": "SUITE 200",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021101",
            "telephone_number": "409-833-5555",
            "fax_number": "409-833-9911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOSCOPY CENTER OF SOUTHEAST TEXAS LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-17",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A",
        "authorized_official_last_name": "SNODGRASS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "008331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107758801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1186180",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Endoscopy Center of Southeast Texas",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Endoscopy Center of Southeast Texas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.