Ambeaux Professional MGMT Ser LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

PA01279 Issued in TX

Legal business name

AMBEAUX PROFESSIONAL MGMT SER LLC

Doing business as

PrimeCare Health System

Practice address

604 S Washington St
Livingston, TX 77351-2074

Phone

(936) 328-8944

Fax

(936) 328-8945

NPI assigned

Dec 16, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Louis Irvin Ambeaux Jr., PANPI 1124220306

Title

Physician Assistant Supervisor

Phone

(936) 328-8944

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PrimeCare Health System Doing business as

Practitioners 3

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.

• Louis Irvin Ambeaux Jr., P.A.

  • Medical Physician Assistant
  • Livingston, TX
  • NPI 1124220306
  NPD (past) Authorized official
• Raymond J Luna, MD

  • Adult Medicine Physician
  • Livingston, TX
  • NPI 1740280692
  NPD (past)
• Dickson O Odero, MD

  • Infectious Disease Physician
  • Lufkin, TX
  • NPI 1972655652
  NPD (past)

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699751180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2074",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773512074",
            "telephone_number": "936-328-8944",
            "fax_number": "936-328-8945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 S WASHINGTON ST",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773512074",
            "telephone_number": "936-328-8944",
            "fax_number": "936-328-8945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBEAUX PROFESSIONAL MGMT SER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AMBEAUX",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_middle_name": "IRVIN",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT SUPERVISOR",
        "authorized_official_telephone_number": "936-328-8944",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "PA01279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MC - GROUP #",
            "identifier": "00664R",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PrimeCare Health System",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Misty Rene Allen, LPC
• Alliance Health Network Inc.
• Alliance Health Network, Inc.
• Alliance Health Network, Inc.
• Amaysing Grace Non-Emergency Medical Transportation, LLC
• Louis Irvin Ambeaux Jr., P.A.
• American Hospice, Inc. (Gentiva)
• Americare EMS Polk County LLC (Americare EMS)
• Victoria Lynn Anderson
• Apostle Home Healthcare, PLLC

• Family Medicine Physician in Livingston, TX
• Providers in Livingston, 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 Aug 22, 2020; 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.