Active NPI
East Texas Surgical Associates, PA
- Surgery Physician
- Beaumont, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- 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
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Charles Gutierrez, M.D.
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryLocations
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
604 Hurst St
Center, TX 75935
Phone (936) 590-4222
1521 S Staples St
#150
Corpus Christi, TX 78404
Phone (361) 882-4000
605 W Gibson St
Jasper, TX 75951
Phone (409) 489-0500
Practitioners & affiliated clinicians
Practitioners 29
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Vascular & Interventional Radiology Physician
- Corpus Christi, TX
- NPI 1669444212
TX
-
- Vascular & Interventional Radiology Physician
- Webster, TX
- NPI 1831337096
TX
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": "193400000X SINGLE SPECIALTY 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.