Organization
BEAUMONT ER PHYSICIANS PLLC
Active
Other names
Beaumont ER Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANNON ORSAK MD (PRESIDENT)
(281) 343-9975
Entity
Organization
Contact information
Practice address
4004 COLLEGE ST, BEAUMONT, TX 77707-4004
(713) 343-9651
(409) 515-1121
Mailing address
12743 CAPRICORN ST STE 400, STAFFORD, TX 77477-3996
(713) 343-9651
(409) 515-1121
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
261QE0002X
Emergency Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00567J
BLUE CROSS BLUE SHIELD
TX
Enumeration date
09/23/2013
Last updated
04/17/2015
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