Beaumont Radiology Group, LLP

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

BEAUMONT RADIOLOGY GROUP, LLP

Practice address

4890 Dowlen Rd
Beaumont, TX 77708-4828

Phone

(409) 838-4772

Fax

(409) 838-6134

NPI assigned

Oct 17, 2006

Last updated

Aug 20, 2009By 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

Mrs. Kathi Manuel

Title

Administration

Phone

(409) 838-4772

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 5

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.

• David Aaron Bosse, M.D.

  • Diagnostic Radiology Physician
  • College Station, TX
  • NPI 1558476507
  NPD (past)
• Matthew Lee Dunn, NP

  • Nurse Practitioner
  • Beaumont, TX
  • NPI 1235330804
  NPD (past)
• Jeffrey R Goldstein, M.D.

  • Vascular & Interventional Radiology Physician
  • Houston, TX
  • NPI 1205832466
  NPD (past)
• Antonio P Sison, MD

  • Diagnostic Radiology Physician
  • Fort Worth, TX
  • NPI 1831280015
  NPD (past)
• Peter N Agomuo, M.D

  • Diagnostic Radiology Physician
  • Lafayette, LA
  • NPI 1245236413
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250726400000",
    "number": "1831270156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4890 DOWLEN RD",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777084828",
            "telephone_number": "409-838-4772",
            "fax_number": "409-838-6134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4890 DOWLEN RD",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777084828",
            "telephone_number": "409-838-4772",
            "fax_number": "409-838-6134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUMONT RADIOLOGY GROUP, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2009-08-20",
        "status": "A",
        "authorized_official_last_name": "MANUEL",
        "authorized_official_first_name": "KATHI",
        "authorized_official_title_or_position": "ADMINISTRATION",
        "authorized_official_telephone_number": "409-838-4772",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD-MEDICARE",
            "identifier": "CP7211",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "00SN29",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127255101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Beaumont Primary Healthcare, PLLC
• Beaumont Psychological Services PC
• Beaumont Recovery and Consulting, Inc.
• Beaumont Retina Consultant PA
• Beaumont Smile Center, P.a.
• Beaumont Smiles Youth Dentistry, PLLC
• Beaumont SNF LLC (The Oasis at Beaumont)

• Specialist in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; 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.