| Beaumont Heart & Vascular Center | |
|
755 N 11th St Ste P3790a Beaumont TX 77702-1500 | |
| (409) 924-3996 | |
| (409) 924-3916 |
| Full Name | Beaumont Heart & Vascular Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 755 N 11th St Ste P3790a, Beaumont, Texas |
| Authorized Official Name and Position | Kelly Marie Bemis (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 8587222358 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beaumont Heart & Vascular Center Dept# 3011, Po Box 4417 Houston TX 77210-4417 Ph: (610) 644-8900 | Beaumont Heart & Vascular Center 755 N 11th St Ste P3790a Beaumont TX 77702-1500 Ph: (409) 924-3996 |
| NPI Number | 1215233374 |
|---|---|
| Provider Enumeration Date | 02/07/2011 |
| Last Update Date | 11/09/2023 |
| Medicare PECOS PAC ID | 2466630421 |
|---|---|
| Medicare Enrollment ID | O20110623000047 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215233374 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Thomas R Lombardo |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1891791091 PECOS PAC ID: 7911999149 Enrollment ID: I20041206000750 |
| Provider Name | Thomas E Hong |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1235121294 PECOS PAC ID: 7517994734 Enrollment ID: I20050720000115 |
| Provider Name | Jorge A Hernandez |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1356338347 PECOS PAC ID: 0345218749 Enrollment ID: I20070716000546 |
| Provider Name | Mark Fasulo |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1366686487 PECOS PAC ID: 2567512718 Enrollment ID: I20090609000382 |
| Provider Name | Allen Mcgrew |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1689909418 PECOS PAC ID: 3072751866 Enrollment ID: I20160706001026 |
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