Provider Demographics
NPI:1669020277
Name:EXCEPTIONAL H C BEAUMONT LLC
Entity Type:Organization
Organization Name:EXCEPTIONAL H C BEAUMONT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SAEED
Authorized Official - Middle Name:S
Authorized Official - Last Name:MAHBOUBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-341-7800
Mailing Address - Street 1:4755 EASTEX FWY
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-7115
Mailing Address - Country:US
Mailing Address - Phone:469-341-7800
Mailing Address - Fax:
Practice Address - Street 1:4755 EASTEX FWY
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-7115
Practice Address - Country:US
Practice Address - Phone:469-341-7800
Practice Address - Fax:346-215-1007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-27
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care