Southeast Texas Psychological Services, PLLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

36418 Issued in TX

Legal business name

SOUTHEAST TEXAS PSYCHOLOGICAL SERVICES, PLLC

Practice address

2615 Calder St Ste 640
Beaumont, TX 77702-1115

Phone

(337) 274-2674

Fax

(409) 813-8523

NPI assigned

Oct 16, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Christopher G Weaver, PSYD

Title

Clinical Director

Phone

(409) 813-8506

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1444953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615766400000",
    "number": "1932570959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 CALDER ST STE 640",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021115",
            "telephone_number": "337-274-2674",
            "fax_number": "214-396-3962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 CALDER ST STE 640",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021115",
            "telephone_number": "337-274-2674",
            "fax_number": "409-813-8523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST TEXAS PSYCHOLOGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-16",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "409-813-8506",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "TX",
            "license": "36418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; 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.