THE MEDICAL CENTER OF SOUTHEAST TEXAS LP (NPI# 1114006749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114006749 |
| Entity Type | Organization |
| Organization Name | THE MEDICAL CENTER OF SOUTHEAST TEXAS LP |
| Other Organization Name | THE MEDICAL CENTER OF SOUTHEAST TEXAS |
| Practice Address |
2555 Jimmy Johnson Blvd Port Arthur TX 77640-2007 |
| Mailing Address |
2555 Jimmy Johnson Blvd Attn: Billing Port Arthur TX 77640-2007 |
| Practice Telephone | 4097247389 |
| Practice Fax Number | 4098535910 |
| Mailing Telephone | 4097247389 |
| Mailing Fax Number | 4098535910 |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2018-04-03 |
| Authorized Official Name | RICHARD D GONZALEZ (HOSPITAL CEO) |
| Authorized Official Telephone | 4097247389 |
| Is Organization Subpart | Y |
| Parent Organization Name | THE MEDICAL CENTER OF SOUTHEAST TEXAS LP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273Y00000X | Rehabilitation Unit | Hospital Units |
| Other Name | Type Code |
|---|---|
| The Medical Center of Southeast Texas | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861467573 | The Medical Center of Southeast Texas Lp | Clinic/Center | 2555 Jimmy Johnson Blvd, Port Arthur, TX 77640-2007 | 2006-02-17 |
| 1316026941 | The Medical Center of Southeast Texas Lp | Psychiatric Unit | 2555 Jimmy Johnson Blvd, Port Arthur, TX 77640-2007 | 2006-11-03 |
| Street Address |
2555 JIMMY JOHNSON BLVD |
| City | PORT ARTHUR |
| State | TX |
| Zip Code | 77640-2007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861467573 | The Medical Center of Southeast Texas Lp | Clinic/Center | 2555 Jimmy Johnson Blvd, Port Arthur, TX 77640-2007 | 2006-02-17 |
| 1265046726 | Sharonda Renee Mouton | Social Worker | 2555 Jimmy Johnson Blvd, Port Arthur, TX 77640-2007 | 2020-09-02 |
| 1164031258 | Julie Vuong Tran | Registered Nurse | 2555 Jimmy Johnson Blvd, Port Arthur, TX 77640-2007 | 2020-07-24 |
| 1639798374 | Diem Vo | Student in an Organized Health Care Education/Training Program | 2555 Jimmy Johnson Blvd, Port Arthur, TX 77640-2007 | 2020-04-13 |
| 1447731955 | Donna Larkins Mitchell | Nurse Practitioner | 2555 Jimmy Johnson Blvd, Port Arthur, TX 77640-2007 | 2018-08-23 |
| 1598252413 | Jennifer Ann Wilson | Specialist/Technologist, Other | 2555 Jimmy Johnson Blvd, Port Arthur, TX 77640-2007 | 2018-04-16 |
| 1598264616 | Connor Patrick O'shaughnessy | Dietitian, Registered | 2555 Jimmy Johnson Blvd, Port Arthur, TX 77640-2007 | 2018-02-04 |
| 1093213555 | Stephanie Rae Dodson | Dietitian, Registered | 2555 Jimmy Johnson Blvd, Port Arthur, TX 77640 | 2018-01-30 |
| 1447767819 | Shannon Huebel Keith | Nurse Practitioner | 2555 Jimmy Johnson Blvd, Port Arthur, TX 77640-2007 | 2018-01-06 |
| 1598271405 | Millennium Neonatolgy Pllc | Pediatrics | 2555 Jimmy Johnson Blvd, Port Arthur, TX 77640-2007 | 2017-12-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275031676 | Grupo Segovia Sc | Specialist | 101 Calle Primera Sur, Adolfo Lopez Mateos, Cozumel, QUINTANA ROO 77640 | 2018-01-31 |
| 1811495575 | Total Care Medical, Pllc | Clinic/Center | 8035 Memorial Blvd Ste B, Port Arthur, TX 77640 | 2018-01-29 |
| 1750805586 | Bv Continuing Care Center Ltd. Co. | Skilled Nursing Facility | 8595 Medical Center Blvd., Port Arthur, TX 77640 | 2017-08-02 |
| 1053840561 | Centro Medico De Cozumel Sa De Cv | General Acute Care Hospital | Calle 1ra Sur No. 101 Adolfo Lopez Mateo, Cozumel, QUINTANA ROO 77640 | 2017-06-08 |
| 1306391719 | Hector Trevino | Dentist | 2780 Fm 365, Port Arthur, TX 77640 | 2016-08-16 |
| 1316325616 | Gulfside Dental Port Arthur Pllc | Dentist | 2780 Hwy 365, Suite C, Port Arthur, TX 77640 | 2015-05-07 |
| 1962894782 | Chris Hale | Specialist/Technologist, Other | 6361 Katy Av, Port Arthur, TX 77640 | 2015-03-03 |
| 1396157681 | Jack 1 Foundation Inc. | Day Training, Developmentally Disabled Services | 235 Procter St., Port Arthur, TX 77640 | 2014-05-21 |
| 1205275054 | Gulf Coast Health Center, Inc | Clinic/Center | 601 Rev Ransom Howard, Bldg B, Port Arthur, TX 77640 | 2013-06-14 |
| 1285909432 | Costamed | General Acute Care Hospital | Calle Primera Sur No. 101, Cozumel, QR 77640 | 2012-03-20 |
| Find all providers in zip 77640 | ||||
| Taxonomy Code | 273Y00000X |
| Grouping | Hospital Units |
| Classification | Rehabilitation Unit |
| In general, a distinct unit of a general acute care hospital that provides care encompassing a comprehensive array of restoration services for the disabled and all support services necessary to help patients attain their maximum functional capacity. Source: AHA Annual Survey p. A10 1996 AHA Guide. For Medicare, a distinct part of a general acute care hospital providing inpatient rehabilitation services that meets the following requirements. Rehabilitation Units have in effect a preadmission screening procedure under which each prospective patient’s condition and medical history are reviewed to determine whether the patient is likely to benefit significantly from an intensive inpatient program or assessment; ensure that the patients receive close medical supervision and furnish, through the use of qualified personnel, rehabilitation nursing, physical therapy and occupational therapy, plus, as needed, speech therapy, social services or psychological services and orthotic and prosthetic services; have a plan of treatment for each inpatient that is established, reviewed, and revised as needed by a physician in consultation with other professional personnel who provide services to the patient; use a coordinated multidisciplinary team approach in the rehabilitation of each inpatient, as documented by periodic clinical entries made in the patient’s medical record to note the patient's status in relationship to goal attainment, and that team conferences are held at least every two weeks to determine the appropriateness of treatment; have a director of rehabilitation who provides services to the unit and its inpatients for at least 20 hours a week, is a doctor of medicine or osteopathy, is licensed under State law to practice medicine or surgery, and has had, after completing a one-year hospital internship at least two years of training or experience in the medical management of inpatients requiring rehabilitation services. |
| Notes: Source: Code of Federal Regulations #42, Section 412.29. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346793890 | Chukwuemeka Ozonwankwo | Rehabilitation Unit | 2111 Washington Cir, Apt 120, Arlington, TX 76011-3320 | 2016-08-02 |
| 1942650577 | Unlocking The Spectrum | Rehabilitation Unit | 9911 Sundew Cir, Houston, TX 77070-1992 | 2016-06-14 |
| 1669851879 | Supplemental Healthcare Inc. | Rehabilitation Unit | 333 Holly Creek Ct Apt 1708, The Woodlands, TX 77381 | 2015-05-20 |
| 1740683200 | Baptist Health System | Rehabilitation Unit | 5630 W Loop 1604 N Ste 108, San Antonio, TX 78251-3806 | 2014-09-29 |
| 1568899391 | Hillcrest Baptist Medical Center | Rehabilitation Unit | 100 Hillcrest Medical Blvd Fl 2, Waco, TX 76712-8897 | 2013-10-11 |
| 1194022749 | Mmc Therapy Enterprises, LLC | Rehabilitation Unit | 4951 Long Prairie Road, Suite 110, Flower Mound, TX 75028 | 2011-02-17 |
| 1437453545 | Vitality Chiropractic and Wellness | Rehabilitation Unit | 1205 Meadowlark Dr, Little Elm, TX 75068-4653 | 2011-01-04 |
| 1699832303 | Procare Therapies PC | Rehabilitation Unit | 515 E. Business Hwy. 83, Suite A, Alamo, TX 78516 | 2007-01-02 |
| 1386705390 | Sierra Providence Health Network | Rehabilitation Unit | 81 Camille Apt 44, El Paso, TX 79912-0011 | 2006-12-13 |
| 1831276930 | Harris County Hospital District | Rehabilitation Unit | 3601 North Macgregor Way, Houston, TX 77004-8004 | 2006-11-01 |
| Find all providers with the same taxonomy | ||||
| City | PORT ARTHUR |
| Zip Code | 77640 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.