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NPI Code Detail

MEDICARE: SPINDLETOP MHMR SERVICES

MEDICARE: SPINDLETOP MHMR SERVICES
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1363LG0600XGerontology Nurse Practitioner
2251B00000XCase Management Agency
3251K00000XPublic Health or Welfare Agency
4101YM0800XMental Health Counselor
5261QD1600XDevelopmental Disabilities Clinic/Center
6261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
7207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1952357550
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPINDLETOP MHMR SERVICES
Provider Business Mailing Address
First Line : 2750 S 8TH ST
Second Line : P O BOX 3846
City : BEAUMONT
State : TX
Zip : 77701-7719
Country : US
Telephone Number : 409-839-1000
Fax Number : 409-839-1066
Provider Business Practice Location Address
First Line : 2750 S 8TH ST
Second Line :
City : BEAUMONT
State : TX
Zip : 77701-7719
Country : US
Telephone Number : 409-839-1000
Fax Number : 409-839-1066
Authorized Official
Title or Position : REIMBURSEMENT MANAGER
Name : ANNIE J SMITH
Credential :
Telephone Number : 409-839-1009
Provider Enumeration Date : 05/25/2006
Last Update Date : 12/05/2022

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1821032665 — MRS. LERA SUSAN KASSEROLER GNP
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1336162429 — MISS CINDY NGUYEN PA
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Directions to “SPINDLETOP MHMR SERVICES ” Practice Location

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