Organization
ABC SURGICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JESSICA EVANS (CREDENTIALING PERSONAL)
(573) 944-3604
Entity
Organization
Contact information
Practice address
6 TWIN CIRCLE DR, BEAUMONT, TX 77706-5304
(409) 781-2747
Mailing address
6 TWIN CIRCLE DR, BEAUMONT, TX 77706-5304
(409) 781-2747
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207R00000X
Internal Medicine Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
261Q00000X
Clinic/Center
—
—
261QP3300X
Pain Clinic/Center
—
—
Other
Enumeration date
04/24/2020
Last updated
04/24/2020
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