Organization
FOLSOM MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BODO BRAUER (OWNER/PROVIDER)
(409) 832-6545
Entity
Organization
Contact information
Practice address
6510 FOLSOM DR, BEAUMONT, TX 77706
(409) 832-6545
(409) 832-7494
Mailing address
6510 FOLSOM DR, BEAUMONT, TX 77706-7274
(409) 832-6545
(409) 832-7494
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
H3231
TX
363LA2200X
Adult Health Nurse Practitioner
583808
TX
363LA2200X
Adult Health Nurse Practitioner
670528
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154849529
NPI
TX
01
—
1174015184
NPI
TX
01
—
1316478506
NPI NUMBER
TX
Enumeration date
08/28/2006
Last updated
07/02/2018
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