Organization
DIAGNOSTIC GROUP IHS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER RUIZ (ADMINISTRATOR)
(409) 813-1677
Entity
Organization
Contact information
Practice address
2200 HIGHWAY 365, NEDERLAND, TX 77627-5506
(409) 722-4321
Mailing address
3406 COLLEGE ST, BEAUMONT, TX 77701-4612
(409) 813-2332
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
AP128428
TX
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
12/31/2015
Last updated
09/21/2022
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