Organization Active NPI

Southeast Texas Infectious Disease PLLC

  • Infectious Disease Physician
  • Beaumont, TX
National Provider Identifier
1992338370
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
SOUTHEAST TEXAS INFECTIOUS DISEASE PLLC
Practice address
2955 Harrison St Ste 204
Beaumont, TX 77702-1156
Phone
(092) 454-0761
Fax
(409) 245-0994
NPI assigned
Feb 13, 2020
Last updated
May 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Authorized official

Name
Shariq Rauf, MDNPI 1528019023
Title
Owner
Phone
(281) 942-8001

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
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X Primary

Addresses

Primary practice location

2955 Harrison St Ste 204
Beaumont, TX 77702-1156

Mailing address

PO Box 590045
Houston, TX 77259-0045
Phone (281) 942-8001

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200416002369 TX Part B Supplier - Clinic/Group Practice 3577993484 Receives reassigned benefits from 4 practitioners
Practice locations: Beaumont, TX

National Provider Directory

National Provider Directory

Locations

2830 Calder St
#T
Beaumont, TX 77702

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1581552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716249600000",
    "number": "1992338370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 590045",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772590045",
            "telephone_number": "281-942-8001",
            "fax_number": "281-724-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 HARRISON ST STE 204",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021156",
            "telephone_number": "092-454-0761",
            "fax_number": "409-245-0994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST TEXAS INFECTIOUS DISEASE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-13",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A",
        "authorized_official_last_name": "RAUF",
        "authorized_official_first_name": "SHARIQ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-942-8001",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.