Organization
SOUTHEAST TEXAS UROLOGY ASSOCIATES, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH DENTON HARRIS IV M.D. (PHYSICIAN/OWNER)
(409) 899-4111
Entity
Organization
Contact information
Practice address
755 N 11TH ST, SUITE P3200, BEAUMONT, TX 77702-1501
(409) 899-4111
(409) 899-5670
Mailing address
755 N 11TH ST, SUITE P3200, BEAUMONT, TX 77702-1501
(409) 899-4111
(409) 899-5670
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00880N
MEDICARE 2ND NUMBER
TX
05
—
109365001
—
TX
05
—
109365002
—
TX
01
—
CG1207
GROUP RAILROAD MEDICARE
TX
Enumeration date
08/16/2006
Last updated
07/27/2007
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