Organization
SURGICAL CRITICAL CARE ASSOCIATES, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARIOUSH KAVOUSPOUR M.D. (PARTNER)
(409) 899-8501
Entity
Organization
Contact information
Practice address
2965 HARRISON ST, SUITE 211, BEAUMONT, TX 77702-1149
(409) 899-8501
(409) 899-8510
Mailing address
PO BOX 12909, BEAUMONT, TX 77726-2909
(409) 899-8501
(409) 899-8510
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
TX
2086S0127X
Trauma Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141564802
—
TX
01
—
CH4595
RR MEDICARE
TX
Enumeration date
09/13/2006
Last updated
09/19/2022
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