Provider Demographics
NPI:1710157722
Name:BEAUMONT NEPHROLOGY ASSOCIATES
Entity Type:Organization
Organization Name:BEAUMONT NEPHROLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOZANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-212-9240
Mailing Address - Street 1:2955 HARRISON ST
Mailing Address - Street 2:#100
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1154
Mailing Address - Country:US
Mailing Address - Phone:409-212-9240
Mailing Address - Fax:409-212-9239
Practice Address - Street 1:930 MARVIN HANCOCK DR
Practice Address - Street 2:ROOM A
Practice Address - City:JASPER
Practice Address - State:TX
Practice Address - Zip Code:75951-4752
Practice Address - Country:US
Practice Address - Phone:409-212-9240
Practice Address - Fax:409-212-9239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty