Black, Jorge Washington

Black, Jorge Washington is an sole proprietor health care provider with primary practice located at 490 Ih 10 N Ste 100 , Beaumont TX 77702-1819. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Black, Jorge Washington can be contacted via phone (409) 212-9988.

Contact Information

Primary practice address
490 Ih 10 N Ste 100 Beaumont TX 77702-1819
Phone: (409) 212-9988
Fax: (409) 212-8449
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 0101235945 Virginia
Allopathic & Osteopathic Physicians / Pediatrics 208000000X Q3336 Texas

Profile Details

NPI number 1518957471
LBN Legal business name Black, Jorge Washington
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 24th, 2005
Last updated Apr 28th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1518957471 NPPES
Virginia MEDICAID 1518957471

Popular Providers