NPIMap

Organization Active NPI

Ut Physicians Specialty Services

  • Pediatrics Physician
  • Beaumont, TX
National Provider Identifier
1669909495
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
UT PHYSICIANS SPECIALTY SERVICES
Practice address
3610 Stagg Dr
Beaumont, TX 77701-3713
Phone
(409) 730-4700
NPI assigned
May 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Authorized official

Name
Andrew R Casas
Title
Chief Operating Officer
Phone
(832) 325-7325

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

3610 Stagg Dr
Beaumont, TX 77701-3713

Mailing address

PO Box 301448
Dallas, TX 75303-1448

Other identifiers 1

IdentifierTypeStateIssuer
195996716MedicaidTX

Other names 1

  • UTPSS BEAUMONT THSTEPS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ut Physicians Specialty Services21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1669909495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 301448",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753031448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 STAGG DR",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777013713",
            "telephone_number": "409-730-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UT PHYSICIANS SPECIALTY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "CASAS",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "832-325-7325"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195996716",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UTPSS BEAUMONT THSTEPS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 11, 2017; 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.