Southeast Texas Medical Associates

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

License

R25266 Issued in TX

Legal business name

SOUTHEAST TEXAS MEDICAL ASSOCIATES

Doing business as

Gulf Coast Diagnostic Services

Practice address

2929 Calder St
Suite 100
Beaumont, TX 77702-1845

Phone

(409) 233-9797

Fax

(409) 839-3174

NPI assigned

Aug 23, 2005

Last updated

Nov 8, 2010By 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. Richard Bryant, RN

Title

Chief Operations Officer

Phone

(409) 833-9797

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Gulf Coast Diagnostic Services Doing business as

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289174400000",
    "number": "1710970066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 CALDER ST",
            "address_2": "SUITE 100",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021845",
            "telephone_number": "409-833-9797",
            "fax_number": "409-839-3174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 CALDER ST",
            "address_2": "SUITE 100",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021845",
            "telephone_number": "409-233-9797",
            "fax_number": "409-839-3174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST TEXAS MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-23",
        "last_updated": "2010-11-08",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "409-833-9797",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "TX",
            "license": "R25266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9540801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gulf Coast Diagnostic Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; 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.