{
"Npi": {
"NPI": "1255524070",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CITY OF BEAUMONT PUBLIC HEALTH DEPARTMENT",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3040 COLLEGE STREET",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BEAUMONT",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77701",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "409-654-3603",
"MailingAddressFaxNumber": "409-832-4270",
"FirstLinePracticeLocationAddress": "3040 COLLEGE STREET",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BEAUMONT",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77701",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "409-654-3603",
"PracticeLocationAddressFaxNumber": "409-832-4270",
"EnumerationDate": "08/24/2007",
"LastUpdateDate": "01/07/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "COLEMAN",
"AuthorizedOfficialFirstName": "KENNETH",
"AuthorizedOfficialMiddleName": "W.",
"AuthorizedOfficialTitle": "PUBLIC HEALTH DIRECTOR",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": "SR.",
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "409-654-3603",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251K00000X",
"TaxonomyName": "Public Health or Welfare Agency",
"LicenseNumber": "251K00000X",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}