Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

College Street Medical Group, PLLC

Organization Family Medicine Physician · NPI 1912233289

College Street Medical Group, PLLC provides Family Medicine Physician services in Beaumont, Texas. Registered with an NPI since 2009.

In the registry since
2009
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5755 College St
Beaumont, TX 77707-3518 Not confirmed with CMS for 15 years — call before visiting
Phone: (409) 840-9300
Fax: (409) 842-4960
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1912233289
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Bodre Rising — Provider/Owner · (409) 840-9300
NPI enumeratedOctober 21, 2009
Last updated in NPPESApril 28, 2011
Mailing address5755 College St, Beaumont, TX 77707-3518

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