ELOISE D TATUM
NPI 1215898887
Military Health Care Provider in Beaumont, TX
- Individual
- Female
- Military Health Care Provider
About ELOISE TATUM
This page provides the complete NPI Profile along with additional information for Eloise Tatum, a provider established in Beaumont, Texas with a medical specialization in Military Health Care Provider. The healthcare provider is registered in the NPI registry with number 1215898887 assigned on November 2025. The practitioner's primary taxonomy code is 171000000X with license number 39-4691662 (). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1215898887 Verify this NPI
- Provider Name
- ELOISE D TATUM
- Other Name
- MRS. MICHELLE RENEE JOHNSON EMPLOYEE
- Other Name Type
- Professional Name (2)
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 2472 PECOS ST BEAUMONT, TX 77702
- Location Phone
- (409) 932-6534
- Mailing Address
- 2472 PECOS ST BEAUMONT, TX 77702
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 11-21-2025
- Last Update Date
- 11-21-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Military Health Care Provider
- Taxonomy Code
- 171000000X
- Type
- Other Service Providers
- License No.
- 39-4691662
- Taxonomy Description
- Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1215898887, enumerated as an "individual" on November 21, 2025.
The provider is located at 2472 PECOS ST BEAUMONT, TX 77702 and the phone number is (409) 932-6534.
Military Health Care Provider with taxonomy code 171000000X.
