Provider Demographics
NPI:1376712554
Name:RPK ANESTHESIA PA.
Entity Type:Organization
Organization Name:RPK ANESTHESIA PA.
Other - Org Name:BEAUMONT PAIN CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:R
Authorized Official - Last Name:REYES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:713-378-3066
Mailing Address - Street 1:PO BOX 5607
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77508-5607
Mailing Address - Country:US
Mailing Address - Phone:713-378-3066
Mailing Address - Fax:713-378-3077
Practice Address - Street 1:155 IH-10 NORTH
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77707-2550
Practice Address - Country:US
Practice Address - Phone:713-378-3066
Practice Address - Fax:713-378-3077
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RPK ANESTHESIA PA.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-21
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0046CCOtherBCBS GROUP #
TX0046CCOtherBCBS GROUP #