Beaumont Family Practice Associates PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

F1914 Issued in TX

Legal business name

BEAUMONT FAMILY PRACTICE ASSOCIATES PA

Doing business as

Southeast Texas Occupational Medicine

Practice address

6450 Folsom
Beaumont, TX 77706

Phone

(409) 835-0524

Fax

(409) 833-2058

NPI assigned

Sep 15, 2006

Organization subpart

Yes

Parent organization

BEAUMONT FAMILY PRACTICE ASSOC. PA.As reported in NPPES

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

Authorized official

Name

Dr. Jay C Proctor III, M.D.

Title

President/Owner

Phone

(409) 835-0524

Specialties & licenses 1

Addresses

Other names 1

• Southeast Texas Occupational Medicine Doing business as

Part of

Beaumont Family Practice

Locations

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467158400000",
    "number": "1629174891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6450 FOLSOM",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77706",
            "telephone_number": "409-835-0524",
            "fax_number": "409-833-2058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6450 FOLSOM",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77706",
            "telephone_number": "409-835-0524",
            "fax_number": "409-833-2058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUMONT FAMILY PRACTICE ASSOCIATES PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BEAUMONT FAMILY PRACTICE ASSOC. PA.",
        "enumeration_date": "2006-09-15",
        "last_updated": "2016-06-29",
        "status": "A",
        "authorized_official_last_name": "PROCTOR",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "409-835-0524",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "F1914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Texas Occupational Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Beaumont Family Dental PA
• Beaumont Family Eye Care PA
• Beaumont Family Urgent Care PLLC
• Beaumont Foot Specialists Inc
• Beaumont Home Health Service, Inc
• Beaumont House Call Doctor PLLC
• Beaumont I Enterprises, LLC (Beaumont Nursing and Rehabilitation)

• Family Medicine Physician in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; 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.