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Organization
BEAUMONT SURGICAL AFFILIATES, LTD
Active
Organization
BEAUMONT SURGICAL AFFILIATES, LTD
Active
Other names
Baptist Beaumont Surgical Affiliates
Organization subpart
No
Provider details
NPI number
Authorized official
PETER BLACH (OFFICER/AUTHORIZED OFFICIAL)
(713) 343-0832
Entity
Organization
Contact information
Practice address
3560 COLLEGE ST, BEAUMONT, TX 77701
(409) 835-7070
(409) 835-6111
Mailing address
3560 COLLEGE ST, BEAUMONT, TX 77701-4614
(409) 835-7070
(409) 835-6111
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
000384
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
092982001
—
TX
01
—
490003964
MEDICARE RAILROAD
TX
01
—
HH1230
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/16/2006
Last updated
03/17/2020
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