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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518957471 | NPPES |
| Virginia | MEDICAID | 1518957471 |
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