Organization Active NPI

Tamerla D Chavis MD,PA

  • Neurological Surgery Physician
  • Beaumont, TX
National Provider Identifier
1306102439
Registry record updated Apr 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
H4230 Issued in TX
Legal business name
TAMERLA D CHAVIS MD,PA
Practice address
755 N 11TH St
Suite P-5500
Beaumont, TX 77702-1500
Phone
(409) 924-8111
NPI assigned
Apr 3, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2012

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

Authorized official

Name
Dr. Tamerla Dawn Chavis, MD
Title
President
Phone
(409) 924-8111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X H4230 TX Primary

Addresses

Primary practice location

755 N 11TH St
Suite P-5500
Beaumont, TX 77702-1500

Mailing address

755 N 11TH St
Suite P-5500
Beaumont, TX 77702-1500
Phone (409) 924-8111

Other identifiers 1

IdentifierTypeStateIssuer
030803301MedicaidTX

National Provider Directory

National Provider Directory

Locations

755 N 11th St
Ste P5500
Beaumont, TX 77702
Phone (409) 924-8111

NPI Registry JSON

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333411200000",
    "number": "1306102439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 N 11TH ST",
            "address_2": "SUITE P-5500",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021500",
            "telephone_number": "409-924-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 N 11TH ST",
            "address_2": "SUITE P-5500",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021500",
            "telephone_number": "409-924-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMERLA D CHAVIS MD,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-03",
        "last_updated": "2012-04-03",
        "status": "A",
        "authorized_official_last_name": "CHAVIS",
        "authorized_official_first_name": "TAMERLA",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "409-924-8111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": "H4230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030803301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Apr 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.