NPIMap

Organization Active NPI

Southeast Texas Neurology,PA

  • Neurology Physician
  • Nederland, TX
National Provider Identifier
1982828604
Registry record updated May 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
SOUTHEAST TEXAS NEUROLOGY,PA
Practice address
2300 Highway 365 Ste 600
Nederland, TX 77627-6258
Phone
(409) 983-2711
Fax
(409) 853-1641
NPI assigned
Apr 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2020

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

Authorized official

Name
Dr. Emem D Udonta, M.DNPI 1851377675
Title
Administrator
Phone
(409) 983-2711

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

2300 Highway 365 Ste 600
Nederland, TX 77627-6258

Mailing address

2300 Highway 365 Ste 600
Nederland, TX 77627-6258
Phone (409) 983-2711

Other identifiers 1

IdentifierTypeStateIssuer
130004816OtherTXMEDICARE RAILROAD

Other names 1

  • MEDICAL NEUROLOGY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050404000150 TX Part B Supplier - Clinic/Group Practice 2466409362 Receives reassigned benefits from 2 practitioners
Practice locations: Nederland, TX

National Provider Directory

National Provider Directory

Locations

2300 Highway 365
Ste 600
Nederland, TX 77627
Phone (409) 983-1021

3780 Memorial Blvd
Port Arthur, TX 77640
Phone (409) 983-1021

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590451200000",
    "number": "1982828604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 HIGHWAY 365 STE 600",
            "city": "NEDERLAND",
            "state": "TX",
            "postal_code": "776276258",
            "telephone_number": "409-983-2711",
            "fax_number": "409-853-1641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HIGHWAY 365 STE 600",
            "city": "NEDERLAND",
            "state": "TX",
            "postal_code": "776276258",
            "telephone_number": "409-983-2711",
            "fax_number": "409-853-1641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST TEXAS NEUROLOGY,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A",
        "authorized_official_last_name": "UDONTA",
        "authorized_official_first_name": "EMEM",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "409-983-2711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "130004816",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICAL NEUROLOGY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nederland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.