Individual provider Active NPI

Everardo Flores Jr., M.D.

  • Diagnostic Radiology Physician
  • Beaumont, TX
National Provider Identifier
1780116764
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
U4196 Issued in TX
Practice address
3080 College St
Beaumont, TX 77701-4606
Phone
(409) 212-5804
NPI assigned
Mar 30, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X U4196 TX Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3080 College St
Beaumont, TX 77701-4606

Mailing address

3080 College St
Beaumont, TX 77701-4606
Phone (409) 212-5804

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240404000176 TX Practitioner - Diagnostic Radiology 5991052334 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Texas Tech University Health Science Center School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Imaging Associates PLLCGroup PAC ID 2163799685, 4 clinicians

Practice addresses (Care Compare)

8375 Chappell Hill Dr
Beaumont, TX 77713-1103
Phone (888) 930-4589

Hospital & facility affiliations

  • Baptist Beaumont Hospital Hospital, Beaumont, TX, CCN 450346
  • Christus Southeast Texas- St Elizabeth Hospital, Beaumont, TX, CCN 450034
  • Memorial Hermann - Texas Medical Center Hospital, Houston, TX, CCN 450068

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Physician Network CurrentSince Mar 5, 2024 Accepting new patients
Coastal Imaging Associates, PLLC Diagnostic Radiology CurrentSince Feb 24, 2024 Accepting new patients

Locations

3555 Stagg Dr
Beaumont, TX 77701
Phone (409) 212-5922

3080 College St
Beaumont, TX 77701
Phone (409) 212-5000

6450 Folsom Dr
Beaumont, TX 77706
Phone (409) 835-0524

3080 Milam St
Beaumont, TX 77701
Phone (409) 347-3621

2501 Jimmy Johnson Blvd
Ste 501A
Port Arthur, TX 77640
Phone (409) 722-6553

1200 E Campbell Rd
Richardson, TX 75081

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1780116764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3080 COLLEGE ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014606",
            "telephone_number": "409-212-5804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 COLLEGE ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014606",
            "telephone_number": "409-212-5804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES",
        "first_name": "EVERARDO",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-30",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "U4196",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.