NPIMap

Organization Active NPI

East Texas Surgical Associates, PA

  • Surgery Physician
  • Beaumont, TX
National Provider Identifier
1497892152
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
EAST TEXAS SURGICAL ASSOCIATES, PA
Practice address
350 Pine Street
Suite 1415
Beaumont, TX 77701-2441
Phone
(409) 924-8600
Fax
(409) 924-8607
NPI assigned
Jan 31, 2007
Last updated
Mar 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Authorized official

Name
Dr. Charles Gutierrez, M.D.NPI 1104807627
Title
Owner
Phone
(409) 924-8600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Primary

Addresses

Primary practice location

350 Pine Street
Suite 1415
Beaumont, TX 77701-2441

Mailing address

350 Pine Street
Suite 1415
Beaumont, TX 77701-2441
Phone (409) 924-8600

Other practice location 1

1521 S Staples St Ste 510
Corpus Christi, TX 78404-3152
Phone (361) 882-4000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050519000893 TX Part B Supplier - Clinic/Group Practice 8022059013 Receives reassigned benefits from 12 practitioners
Practice locations: Beaumont, TX; Corpus Christi, TX; Mont Belvieu, TX

National Provider Directory

National Provider Directory

Locations

2707 W Baker Rd
Ste A
Baytown, TX 77521
Phone (409) 924-8600

350 Pine St
Ste 1415
Beaumont, TX 77701
Phone (409) 924-8600

1521 S Staples St
#150
Corpus Christi, TX 78404
Phone (361) 882-4000

1521 S Staples St
Ste 510
Corpus Christi, TX 78404
Phone (361) 882-4000

2043 S Wheeler St
Jasper, TX 75951
Phone (409) 383-1200

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1497892152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 PINE STREET",
            "address_2": "SUITE 1415",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777012441",
            "telephone_number": "409-924-8600",
            "fax_number": "409-924-8607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 PINE STREET",
            "address_2": "SUITE 1415",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777012441",
            "telephone_number": "409-924-8600",
            "fax_number": "409-924-8607"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1521 S Staples St Ste 510",
            "address_purpose": "LOCATION",
            "city": "Corpus Christi",
            "state": "TX",
            "postal_code": "784043152",
            "country_code": "US",
            "telephone_number": "361-882-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EAST TEXAS SURGICAL ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-924-8600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.