Provider Demographics
NPI:1922388503
Name:ALTUS RADIATION ONCOLOGY BEAUMONT, LP
Entity Type:Organization
Organization Name:ALTUS RADIATION ONCOLOGY BEAUMONT, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. REG. VP
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-981-5580
Mailing Address - Street 1:310 N 11TH ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1802
Mailing Address - Country:US
Mailing Address - Phone:409-981-5510
Mailing Address - Fax:409-981-5511
Practice Address - Street 1:310 N 11TH ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1802
Practice Address - Country:US
Practice Address - Phone:409-981-5510
Practice Address - Fax:409-981-5511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation