Organization
BEAUMONT KIDNEY SPECIALISTS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND DERDERIAN M.D. (OWNER)
(409) 554-0911
Entity
Organization
Contact information
Practice address
2965 HARRISON STREET, SUITE 317, BEAUMONT, TX 77702-1150
(409) 554-0911
(409) 554-0912
Mailing address
2965 HARRISON STREET, SUITE 317, BEAUMONT, TX 77702-1150
(409) 554-0911
(409) 554-0912
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
11/08/2012
Last updated
11/08/2012
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