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General NPI Number Information
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NPI Number | 1962477406
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Entity Type | Organization
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Legal Business Name | SOUTHEAST TEXAS EAR, NOSE & THROAT, LLP
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Dates
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Enumeration Date | 02/20/2006
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Last Update Date | 10/05/2020
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Provider Practice Location Address
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Address Line | 740 HOSPITAL DR SUITE 300
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City | BEAUMONT
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State | TX
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Zip | 77701-4666
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Country | US
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Telephone | 409-212-8111
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Fax | 409-981-1787
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Provider Business Mailing Address
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Address Line | 740 HOSPITAL DR SUITE 300
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City | BEAUMONT
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State | TX
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Zip | 77701-4666
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Country | US
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Telephone | 409-212-8111
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Fax | 409-981-1787
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. CARL CAREY JORDAN
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Credential | M.D.
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Telephone | 409-212-8111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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