MEDICARE: SOUTHEAST TEXAS PULMONARY ASSOCIATES LLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician
3	207RS0012X	Sleep Medicine (Internal Medicine) Physician
4	207RP1001X	Pulmonary Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578551859
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHEAST TEXAS PULMONARY ASSOCIATES LLP

Provider Business Mailing Address
First Line	:	3030 NORTH ST
Second Line	:	STE 510
City	:	BEAUMONT
State	:	TX
Zip	:	77702-1433
Country	:	US
Telephone Number	:	409-896-5000
Fax Number	:	409-896-5926

Provider Business Practice Location Address
First Line	:	3030 NORTH ST
Second Line	:	STE 510
City	:	BEAUMONT
State	:	TX
Zip	:	77702-1433
Country	:	US
Telephone Number	:	409-896-5000
Fax Number	:	409-896-5926

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. JOLENE STADEL
Credential	:
Telephone Number	:	409-896-5000

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	11/18/2008

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Directions to “SOUTHEAST TEXAS PULMONARY ASSOCIATES LLP ” Practice Location

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