NPIMap

Organization Active NPI

The Medical Center of Southeast Texas LP

  • General Acute Care Hospital
  • Port Arthur, TX
National Provider Identifier
1861467573
Registry record updated Apr 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
000464 Issued in TX
Legal business name
THE MEDICAL CENTER OF SOUTHEAST TEXAS LP
Practice address
2555 Jimmy Johnson Blvd
Port Arthur, TX 77640-2007
Phone
(409) 724-7389
Fax
(409) 853-5917
NPI assigned
Feb 17, 2006
Last updated
Apr 3, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2018

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

Authorized official

Name
Richard D Gonzalez
Title
Hospital Ceo
Phone
(409) 724-7389

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 000464 TX
Critical Access Hospital Clinic/Center 261QC0050X 000464 TX
General Acute Care Hospital 282N00000X 000464 TX Primary

Addresses

Primary practice location

2555 Jimmy Johnson Blvd
Port Arthur, TX 77640-2007

Mailing address

2555 Jimmy Johnson Blvd
Attn: Billing
Port Arthur, TX 77640-2007
Phone (409) 724-7389

Other identifiers 4

IdentifierTypeStateIssuer
1731862MedicaidLA
HH0567OtherTXBLUE CROSS
163925402MedicaidTX
163925401MedicaidTX

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2630 Hwy 365
Nederland, TX 77627
Phone (409) 727-2321

2630 Hwy 365
Sleep Lab
Nederland, TX 77627
Phone (409) 853-5900

2555 Jimmy Johnson Blvd
#L
Port Arthur, TX 77640
Phone (409) 853-5900

2875 Jimmy Johnson Blvd
Port Arthur, TX 77640
Phone (409) 853-5900

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522713600000",
    "number": "1861467573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 JIMMY JOHNSON BLVD",
            "address_2": "ATTN: BILLING",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776402007",
            "telephone_number": "409-724-7389",
            "fax_number": "409-853-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 JIMMY JOHNSON BLVD",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776402007",
            "telephone_number": "409-724-7389",
            "fax_number": "409-853-5917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MEDICAL CENTER OF SOUTHEAST TEXAS LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-17",
        "last_updated": "2018-04-03",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "HOSPITAL CEO",
        "authorized_official_telephone_number": "409-724-7389"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "000464",
            "primary": false
        },
        {
            "code": "261QC0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Critical Access Hospital",
            "state": "TX",
            "license": "000464",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "TX",
            "license": "000464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1731862",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "HH0567",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163925402",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163925401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Arthur, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2018; 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.