COLLEGE STREET MEDICAL GROUP, P.L.L.C. - NPI 1912233289

Q: What is College Street Medical Group, P.L.L.C.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

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About College Street Medical Group, P.l.l.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COLLEGE STREET MEDICAL GROUP, P.L.L.C. (NPI 1912233289) is a healthcare organization registered as a family medicine in Beaumont, Texas and active in the NPI registry since October 2009. The organization lists Bodre Rising, Provider/owner, as its authorized official.

NPPES Registry Identity

NPI1912233289

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameCOLLEGE STREET MEDICAL GROUP, P.L.L.C.

Location Address5755 COLLEGE STBeaumont, TX 77707-3518

Mailing Address5755 College StBeaumont, TX 77707-3518 · (409) 840-9300 · Fax (409) 842-4960

Phone(409) 840-9300

Fax(409) 842-4960

Organization SubpartNo

Authorized OfficialBodre RisingProvider/owner · (409) 840-9300

Enumeration DateOctober 21, 2009

Last NPPES UpdateApril 28, 2011

✔ NPI 1912233289 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

5755 COLLEGE ST, Beaumont, TX 77707

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Other Identifiers 2

Medicare NSC6500190001TX

Medicare PINTXB107654TX

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TRIANGLE MEDICAL SUPPLY, LLC

Durable Medical Equipment & Medical Supplies

5755 COLLEGE ST, SUITE S
BEAUMONT, TX 77707

Jefferson County (409) 840-9300

RISING CHIROPRACTIC CLINIC

Chiropractor

5755 COLLEGE ST
BEAUMONT, TX 77707

Jefferson County (409) 840-9300

INFINITY DIAGNOSTICS CENTER BEAUMONT LLC

Clinic/Center (Magnetic Resonance Imaging (MRI))

5755 COLLEGE ST
BEAUMONT, TX 77707

Jefferson County (409) 333-1487

DR. BODRE M RISING DC

Chiropractor

5755 COLLEGE ST
BEAUMONT, TX 77707

Jefferson County (409) 840-9300

MS. NANCY GAIL BOONE FNP

Nurse Practitioner (Family)

5755 COLLEGE ST
BEAUMONT, TX 77707

Jefferson County (409) 840-9300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is College Street Medical Group, P.L.L.C.'s NPI number?

The NPI number for College Street Medical Group, P.L.L.C. is 1912233289. It was assigned to this organization in the NPPES registry on October 21, 2009.

Where is College Street Medical Group, P.L.L.C. located?

College Street Medical Group, P.L.L.C. is located at 5755 College St, Beaumont, TX 77707. The listed phone number is (409) 840-9300.

What is College Street Medical Group, P.L.L.C.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for College Street Medical Group, P.L.L.C. was last updated on April 28, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.