Organization
LAMAR UNIVERSITY STUDENT HEALTH CTR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN GRAY RNMSNENP (COORDINATOR/NURSE)
(409) 880-8466
Entity
Organization
Contact information
Practice address
857 E VIRGINIA ST, BEAUMONT, TX 77705-5546
(409) 880-8466
(409) 880-7703
Mailing address
P O BOX 10015, 857 E VIRGINIA, BEAUMONT, TX 77710-5546
(409) 880-8466
(409) 880-7703
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
618115
TX
Other
Enumeration date
07/21/2010
Last updated
07/21/2010
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