Beaumont Chronic Pain LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

MDE3137 Issued in TX

Legal business name

BEAUMONT CHRONIC PAIN LLC

Practice address

5220 Eastex Fwy
Beaumont, TX 77708-5320

Phone

(409) 924-8600

Fax

(409) 924-8611

NPI assigned

Aug 24, 2009

Organization subpart

No

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

Authorized official

Name

Dr. John Q a Webb Jr., MD

Title

Medical Director

Phone

(409) 924-8600

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251072000000",
    "number": "1598998627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 EASTEX FWY",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777085320",
            "telephone_number": "409-924-8600",
            "fax_number": "409-924-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 EASTEX FWY",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777085320",
            "telephone_number": "409-924-8600",
            "fax_number": "409-924-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUMONT CHRONIC PAIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-24",
        "last_updated": "2009-08-24",
        "status": "A",
        "authorized_official_last_name": "WEBB",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "Q A",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "409-924-8600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "MDE3137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7772517",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1241770",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "8AM940",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2009; 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.