GOLDEN TRIANGLE INTERVENTIONAL PAIN ASSOCIATES LLC (NPI# 1386186369) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386186369 |
| Entity Type | Organization |
| Organization Name | GOLDEN TRIANGLE INTERVENTIONAL PAIN ASSOCIATES LLC |
| Practice Address |
87 Interstate 10 N Suite 221 Beaumont TX 77707-2544 |
| Practice Telephone | 4095540545 |
| Practice Fax Number | 4065540921 |
| Mailing Telephone | 4095540545 |
| Mailing Fax Number | 4065540921 |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2017-03-17 |
| Authorized Official Name | CRAIG CHARLESTON (OWNER) |
| Authorized Official Telephone | 4798576751 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
87 INTERSTATE 10 N SUITE 221 |
| City | BEAUMONT |
| State | TX |
| Zip Code | 77707-2544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740694124 | Corrie Brackin | Occupational Therapist | 87 Interstate 10 N, Suite 225, Beaumont, TX 77707-2544 | 2014-06-13 |
| 1497262794 | Heather Ann Knighton | Speech-Language Pathologist | 87 Interstate 10 N, Beaumont, TX 77707-2544 | 2018-01-08 |
| 1790299212 | Myria Lee Stepp | Occupational Therapy Assistant | 87 Interstate 10 N, Beaumont, TX 77707-2544 | 2017-11-20 |
| 1922542562 | Courtney Jones | Specialist/Technologist | 87 Interstate 10 N, Suite 225, Beaumont, TX 77707-2544 | 2016-12-16 |
| 1003366386 | Amanda Holbert | Specialist/Technologist | 87 Interstate 10 N, Suite 225, Beaumont, TX 77707-2544 | 2016-10-10 |
| 1578915773 | Heidi Odom | Specialist/Technologist | 87 Interstate 10 N, Beaumont, TX 77707-2544 | 2016-07-12 |
| 1194196931 | Ellen Baker | Speech-Language Pathologist | 87 Interstate 10 N, Suite 225, Beaumont, TX 77707-2544 | 2015-10-19 |
| 1083014740 | Monique Estelle De Pau | Occupational Therapist | 87 Interstate 10 N, 225, Beaumont, TX 77707-2544 | 2014-09-01 |
| 1992104632 | Mary Margaret Mccormick | Speech-Language Pathologist | 87 Interstate 10 N, Suite 225, Beaumont, TX 77707-2544 | 2014-08-19 |
| 1437564812 | Alyssa Nicole Deramus | Speech-Language Pathologist | 87 Interstate 10 N, Frontage Rd #225, Beaumont, TX 77707-2544 | 2014-06-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437718004 | Kelsey Marie Burt | Speech-Language Pathologist | 87 I-10, Beaumont, TX 77707 | 2019-06-07 |
| 1245898808 | Primary Care Anywhere, Pllc | Nurse Practitioner | 4347 Phelan, Suite 101, Beaumont, TX 77707 | 2019-05-30 |
| 1598321663 | Kacy Keitha Priddy | Occupational Therapist | 1846 I-10 S, Suite 102, Beaumont, TX 77707 | 2019-05-14 |
| 1144791963 | Jeffery Ray Manzer | Counselor | 3350 Dowlen Rd Suite J, Beaumont, TX 77707 | 2018-12-06 |
| 1497247217 | Haley Hebert | Speech-Language Pathologist | 87 I 10 N, Suite 225, Beaumont, TX 77707 | 2018-06-06 |
| 1548712383 | Taylor Miguez | Speech-Language Pathologist | 87 I-10 Frontage Rd #225, Beaumont, TX 77707 | 2016-10-27 |
| 1720534043 | Jacie Woodson | Speech-Language Pathologist | 87 I-10 Frontage Rd. 225, Beaumont, TX 77707 | 2016-08-28 |
| 1285187047 | Paula Boudreaux | Speech-Language Pathologist | 87 I-10 Frontage Rd, Suite 225, Beaumont, TX 77707 | 2016-07-28 |
| 1790138568 | Meagan Alyse Hartwick | Speech-Language Pathologist | 87 I-10 Frontage Rd., 225, Beaumont, TX 77707 | 2016-07-18 |
| 1376992578 | Laurie Lynette Jansky | Family Medicine | 3650 Laurel Ave, Beaumont, TX 77707 | 2016-06-08 |
| Find all providers in zip 77707 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972757706 | Pasadena Pain Management Consultants, Pa. | Anesthesiology | 155 Ih 10 N Ste 1, Beaumont, TX 77707-2550 | 2008-11-06 |
| 1760952022 | S E Texas Pain Management Pllc | Anesthesiology | 755 N 11th St Ste P2280, Beaumont, TX 77702-1525 | 2018-11-29 |
| 1720324809 | Universal Pain Management, Pllc | Anesthesiology | 755 N 11th St, Suite P2280, Beaumont, TX 77702-1500 | 2012-12-18 |
| 1477836260 | Anesthesia Associates Pain Institute Pllc | Anesthesiology | 740 Hospital Dr, Suite 150, Beaumont, TX 77701-4664 | 2011-09-28 |
| 1295926475 | Sassan Cyrus Ehdaie | Anesthesiology | 755 N 11th St, Suite P2280, Beaumont, TX 77702-1500 | 2007-08-05 |
| 1942332242 | Daniel Lee Harris | Anesthesiology | 755 N 11th St, Suite P5600, Beaumont, TX 77702-1517 | 2007-03-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033930 | Phuong Dinh Nguyen | Anesthesiology | 11726 E Streamertail Cir # 2, Cypress, TX 77433-6732 | 2020-11-08 |
| 1699375576 | Prwcswtx LLC | Anesthesiology | 700 Paredes Ave Ste 107, Brownsville, TX 78521-2169 | 2020-10-29 |
| 1235742388 | Tricity Pain Associates Pa | Anesthesiology | 14800 San Pedro Ave Ste 115, San Antonio, TX 78232-3734 | 2020-08-28 |
| 1669081915 | Laila Pm&a Group Inc | Anesthesiology | 1803 Longwood Ct, Allen, TX 75013-3074 | 2020-07-23 |
| 1164050498 | Manuel Ybarra Md | Anesthesiology | 255 E Sonterra Blvd Ste 203, San Antonio, TX 78258-4076 | 2020-03-31 |
| 1104451079 | Daniel Dalton Dubose, Md, Pa | Anesthesiology | 201 Crown Pointe Blvd Ste 200, Willow Park, TX 76087-1304 | 2020-03-11 |
| 1700423738 | Esplanade Medical Services Pllc | Anesthesiology | 2024 W 15th St # F-366, Plano, TX 75075-7363 | 2019-12-10 |
| 1760027700 | Sameer Syed, Md, Pa | Anesthesiology | 3151 W 15th St Ste B, Plano, TX 75075-7731 | 2019-11-13 |
| 1518501030 | Institute of Precision Pain Medicine, Pllc | Anesthesiology | 13725 Northwest Blvd Ste 120a, Corpus Christi, TX 78410-3743 | 2019-10-29 |
| 1629628672 | Yancey Pain & Spine, Lllp | Anesthesiology | 9200 Pinecroft Dr Ste 330, Shenandoah, TX 77380-3279 | 2019-09-11 |
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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.