MRS. ELYSE LYNN BRACK (NPI# 1235486036) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235486036 |
| Entity Type | Individual |
| Full Name | MRS. ELYSE LYNN BRACK |
| Other Name | MISS ELYSE LYNN DOBRICK |
| Credential | PA-C |
| Practice Address |
3560 Delaware St Suite 901 Beaumont TX 77706-3067 |
| Practice Telephone | 4098983900 |
| Practice Fax Number | 4098983901 |
| Mailing Telephone | 4098983900 |
| Mailing Fax Number | 4098983901 |
| Enumeration Date | 2012-08-10 |
| Last Update Date | 2018-12-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA07970 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3560 DELAWARE ST SUITE 901 |
| City | BEAUMONT |
| State | TX |
| Zip Code | 77706-3067 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629071915 | Dave S. Carpenter | Dentist | 3560 Delaware St, Ste 1003, Beaumont, TX 77706-3026 | 2005-05-31 |
| 1780234229 | Morgan Mayeux | Pathology | 3560 Delaware St, Beaumont, TX 77706-3067 | 2019-09-17 |
| 1033634514 | Lindsey Kathleen Hullett | Internal Medicine | 3560 Delaware St, Beaumont, TX 77706-3067 | 2017-08-07 |
| 1508392317 | Reeti K Joshi, Md Pa | Internal Medicine | 3560 Delaware St, 301, Beaumont, TX 77706-3067 | 2017-05-11 |
| 1578947438 | Desiree Rice | Counselor | 3560 Delaware St, Suite 1205, Beaumont, TX 77706-3067 | 2015-07-10 |
| 1528482486 | Dexter Simmons | Physical Therapist | 3560 Delaware St, Suite# 301, Beaumont, TX 77706-3067 | 2014-02-13 |
| 1649510694 | Jeniffer Kay Esclovon | Counselor | 3560 Delaware St, Suite 502, Beaumont, TX 77706-3067 | 2013-02-27 |
| 1780931154 | Bethanne Fondren Carson | Nurse Practitioner | 3560 Delaware St, Suite 502, Beaumont, TX 77706-3067 | 2012-08-05 |
| 1255686226 | Beaumont Smile Center, P.a. | Dentist | 3560 Delaware St, Suite 102, Beaumont, TX 77706-3067 | 2012-07-16 |
| 1033485669 | Morrell Dermatology, P.a. | Dermatology | 3560 Delaware St, Suite 901, Beaumont, TX 77706-3000 | 2012-03-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982176293 | Allen Family Home Care LLC | In Home Supportive Care | 4055 Dowlen Rd Ste 112, Beaumont, TX 77706 | 2018-12-27 |
| 1730661174 | Joseph Pryor Ingram | Counselor | 5450 Folsom Road #3, Beaumont, TX 77706 | 2018-09-02 |
| 1336644582 | Jenny Lee Broaddus | Counselor | 8150 N. Major Dr., Beaumont, TX 77706 | 2018-03-29 |
| 1528584026 | Amanthia Peace Williams | Pedorthist | 3645 Calder Ave., Beaumont, TX 77706 | 2017-08-16 |
| 1356863286 | Nicole Denise Williams | Speech-Language Pathologist | 970 North 23rd Street, Beaumont, TX 77706 | 2017-07-12 |
| 1487038923 | Associates for Dental Health, Pllc | Dentist | 415 Dowlen Rd Ste A, Beaumont, TX 77706 | 2015-07-15 |
| 1508264532 | Rose Anne Essex | Dietitian, Registered | 3510 Charleston Ln, Beaumont, TX 77706 | 2014-12-08 |
| 1780001933 | C. Asteris, Inc. | Contractor | 1465 W. Lucas Dr., Beaumont, TX 77706 | 2014-03-26 |
| 1376985820 | Erica J Hayes M D P A | Preferred Provider Organization | 4a Bayou Brandt Drive, Beaumont, TX 77706 | 2013-07-25 |
| 1194162909 | Hezron Omanga | Pharmacist | 3585 N. Dowlen Road, Beaumont, TX 77706 | 2013-06-03 |
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| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699239145 | Michael Delauney Dukate | Physician Assistant | 2965 Harrison St Ste 220, Beaumont, TX 77702-1149 | 2019-01-29 |
| 1427561786 | Colette Lavoy | Physician Assistant | 81 Highland Springs Ave Ste 100, Beaumont, CA 92223-3170 | 2017-11-08 |
| 1639621758 | Jason Allen Fondrick | Physician Assistant | 3030 North St Ste 430, Beaumont, TX 77702-1434 | 2016-10-25 |
| 1457806424 | Adriana Barrier | Physician Assistant | 1361 Mandrake Way, Beaumont, CA 92223-8467 | 2016-08-19 |
| 1235510504 | Randy Steven Yergenson | Physician Assistant | 222 Drake Ave, Beaumont, CA 92223-7512 | 2015-06-12 |
| 1376937003 | Winnie Community Hospital LLC | Physician Assistant | 85 Ih 10 N Ste 112, Beaumont, TX 77707 | 2015-03-19 |
| 1134540560 | Tommy Kent Sims | Physician Assistant | 5030 Highway 69 S, Beaumont, TX 77705-1258 | 2014-01-03 |
| 1396084992 | Courtney Marie Guidry | Physician Assistant | 755 N 11th St Ste P5200, Beaumont, TX 77702 | 2013-02-04 |
| 1285911412 | Nicholas Rene Alonzo | Physician Assistant | 81 Highland Springs Ave Ste 103, Beaumont, CA 92223-3170 | 2011-11-16 |
| 1770673782 | Stephen Livain Richard | Physician Assistant | 2890 N St, Christus Minor Care Clinic, Beaumont, TX 77702 | 2006-10-13 |
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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.