The Med Clinic, PLLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

465574 Issued in TX

Legal business name

THE MED CLINIC, PLLC

Practice address

3705 9TH Ave
Port Arthur, TX 77642-4423

Phone

(409) 985-8100

Fax

(409) 985-4778

NPI assigned

Nov 5, 2010

Organization subpart

No

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

Authorized official

Name

Beverly A St. Julien, MSN, CFNP

Title

Owner

Phone

(409) 985-8100

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1288915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288915200000",
    "number": "1790086882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 9TH AVE",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776424423",
            "telephone_number": "409-985-8100",
            "fax_number": "409-985-4778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 9TH AVE",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776424423",
            "telephone_number": "409-985-8100",
            "fax_number": "409-985-4778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MED CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-05",
        "last_updated": "2010-11-05",
        "status": "A",
        "authorized_official_last_name": "ST. JULIEN",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-985-8100",
        "authorized_official_credential": "MSN, CFNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "465574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Texas Primary Care PLLC
• The Hughen Center, Inc.
• The Hughen Center, Inc.
• The Jaymes Rehabilitation Center Inc
• The Med Clinic
• The Medical Center of Southeast Texas LP
• The Medical Center of Southeast Texas LP
• The Medical Center of Southeast Texas LP
• Marsha Thigpen, M.D.
• Leonard M. Thome, M.D.

• Nurse Practitioner in Port Arthur, TX
• Providers in Port Arthur, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.