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General NPI Number Information
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NPI Number | 1497776751
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Entity Type | Organization
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Legal Business Name | BEAUMONT CANCER INSTITUTE, P.A.
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3455 STAGG DR SUITE 102
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City | BEAUMONT
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State | TX
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Zip | 77701-4521
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Country | US
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Telephone | 409-813-1974
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Fax | 409-813-2486
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Provider Business Mailing Address
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Address Line | 3455 STAGG DR SUITE 102
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City | BEAUMONT
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State | TX
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Zip | 77701-4521
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Country | US
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Telephone | 409-813-1974
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Fax | 409-813-2486
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Authorized Official
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Title or Position | OWNER
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Name | MAHESH D KANOJIA
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Credential | MD
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Telephone | 409-813-1974
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | F8907
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License Number State | TX
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