| Raul D. Isern Jr M.d.p.a | |
|
3438 Fannin St Bldg. 3 Beaumont TX 77701-3803 | |
| (409) 835-2677 | |
| (409) 835-0464 |
| Full Name | Raul D. Isern Jr M.d.p.a |
|---|---|
| Speciality | Clinic/Center |
| Location | 3438 Fannin St, Beaumont, Texas |
| Authorized Official Name and Position | Raul D. Isern (PRESIDENT) |
| Authorized Official Contact | 4098352677 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Raul D. Isern Jr M.d.p.a 3438 Fannin St Bldg. 3 Beaumont TX 77701-3803 Ph: (409) 835-2677 | Raul D. Isern Jr M.d.p.a 3438 Fannin St Bldg. 3 Beaumont TX 77701-3803 Ph: (409) 835-2677 |
| NPI Number | 1427178995 |
|---|---|
| Provider Enumeration Date | 03/30/2007 |
| Last Update Date | 03/10/2014 |
| Medicare PECOS PAC ID | 5092945261 |
|---|---|
| Medicare Enrollment ID | O20140310000163 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427178995 | NPI | - | NPPES |
| P000R26Y6 | Medicaid | TX | |
| 460-11-9818 | Other | SS# |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | H3476 (Texas) | Primary |
| Provider Name | Raul D Isern |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417081852 PECOS PAC ID: 9830220144 Enrollment ID: I20100701000044 |
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