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General NPI Number Information
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NPI Number | 1538503024
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Entity Type | Organization
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Legal Business Name | GOLDEN TRIANGLE EMERGENCY PHYSICIANS
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Dates
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Enumeration Date | 04/26/2013
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Last Update Date | 08/20/2014
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Provider Practice Location Address
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Address Line | 6025 METROPOLITAN
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City | BEAUMONT
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State | TX
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Zip | 77706
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Country | US
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Telephone | 409-237-5870
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1921
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City | BELLAIRE
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State | TX
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Zip | 77402-1921
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Country | US
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Telephone | 409-237-5870
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | TOM VO
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Credential |
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Telephone | 409-237-5870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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