Individual provider Active NPI

Ruben D Victores, MD

  • Obstetrics & Gynecology Physician
  • Beaumont, TX
National Provider Identifier
1841284189
Registry record updated Jun 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
H9727 Issued in TX
Practice address
755 N 11TH St
Suite P4200
Beaumont, TX 77702-1501
Phone
(409) 899-1499
Fax
(409) 899-1354
NPI assigned
Sep 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X H9727 TX Primary

Addresses

Primary practice location

755 N 11TH St
Suite P4200
Beaumont, TX 77702-1501

Mailing address

755 N 11TH St
Suite P4200
Beaumont, TX 77702-1501
Phone (409) 899-1499

Other identifiers 2

IdentifierTypeStateIssuer
123177102MedicaidTX
160037182OtherTXMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Oct 1, 2014 through Oct 1, 2026

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Texas OB GYN Associates PA Obstetrics & Gynecology Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213228800000",
    "number": "1841284189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 N 11TH ST",
            "address_2": "SUITE P4200",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021501",
            "telephone_number": "409-899-1499",
            "fax_number": "409-899-1354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 N 11TH ST",
            "address_2": "SUITE P4200",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021501",
            "telephone_number": "409-899-1499",
            "fax_number": "409-899-1354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICTORES",
        "first_name": "RUBEN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-01",
        "last_updated": "2008-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "H9727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123177102",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "160037182",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.