Healthcare Provider Details

I. General information

NPI: 1912981739
Provider Name (Legal Business Name): SCOTT EUGENE CALDWELL P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2005
Last Update Date: 08/06/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3460 N. DOWLEN RD
BEAUMONT TX
77706-1690
US

IV. Provider business mailing address

3460 N. DOWLEN RD
BEAUMONT TX
77706-1690
US

V. Phone/Fax

Practice location:
  • Phone: 409-838-0346
  • Fax: 409-839-3720
Mailing address:
  • Phone: 409-838-0346
  • Fax: 409-839-3720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA00442
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA00442
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: