Provider Demographics
NPI:1417399080
Name:RELIANT PHYSICIANS OF SOUTHEAST TEXAS PLLC
Entity Type:Organization
Organization Name:RELIANT PHYSICIANS OF SOUTHEAST TEXAS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:EARLE
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:THORNHILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-212-1533
Mailing Address - Street 1:3070 COLLEGE ST
Mailing Address - Street 2:SUITE 401
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701-4691
Mailing Address - Country:US
Mailing Address - Phone:409-212-1533
Mailing Address - Fax:
Practice Address - Street 1:3070 COLLEGE STREET
Practice Address - Street 2:SUITE 401
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701
Practice Address - Country:US
Practice Address - Phone:409-212-1533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-24
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX208M00000X282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital