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NPI Code Detail

MEDICARE: MEDICAL PLUS

MEDICARE: MEDICAL PLUS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1346402666
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDICAL PLUS
Provider Business Mailing Address
First Line : 6622 PHELAN BLVD
Second Line :
City : BEAUMONT
State : TX
Zip : 77706-5966
Country : US
Telephone Number : 409-860-5570
Fax Number :
Provider Business Practice Location Address
First Line : 6622 PHELAN BLVD
Second Line :
City : BEAUMONT
State : TX
Zip : 77706-5966
Country : US
Telephone Number : 409-860-5570
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MICHAEL HOLMES
Credential : MD
Telephone Number : 409-860-5570
Provider Enumeration Date : 06/27/2008
Last Update Date : 06/27/2008

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Directions to “MEDICAL PLUS ” Practice Location

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