Organization
BEAUMONT RETINA CONSULTANT PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRAHAM DOUGLAS AVERY MD (OWNER)
(409) 832-8883
Entity
Organization
Contact information
Practice address
740 HOSPITAL DR, SUITE 200, BEAUMONT, TX 77701-4664
(409) 832-8883
(409) 833-5755
Mailing address
740 HOSPITAL DR, SUITE 200, BEAUMONT, TX 77701-4664
(409) 832-8883
(409) 833-5755
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176154601
—
TX
Enumeration date
11/26/2007
Last updated
06/26/2008
Update your record
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