# LAMAR UNIVERSITY STUDENT HEALTH CTR

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003129891
- **Authorized official:** SHAWN GRAY RNMSNENP (COORDINATOR/NURSE)
- **Authorized official phone:** (409) 880-8466

## Contact information

- **Practice address:** 857 E VIRGINIA ST, BEAUMONT, TX 77705-5546
- **Practice address phone:** (409) 880-8466
- **Practice address fax:** (409) 880-7703
- **Mailing address:** P O BOX 10015, 857 E VIRGINIA, BEAUMONT, TX 77710-5546
- **Mailing address phone:** (409) 880-8466
- **Mailing address fax:** (409) 880-7703

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 618115 | TX | Yes |

## Other

- **Enumeration date:** 07/21/2010
- **Last updated:** 07/21/2010