Provider Demographics
NPI:1902891187
Name:ALFORD, NATHANIEL JEFFERSON JR (MD)
Entity Type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:JEFFERSON
Last Name:ALFORD
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 NORTH ST
Mailing Address - Street 2:SUITE 510
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1433
Mailing Address - Country:US
Mailing Address - Phone:409-896-5000
Mailing Address - Fax:409-896-5926
Practice Address - Street 1:3030 NORTH ST
Practice Address - Street 2:SUITE 510
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1433
Practice Address - Country:US
Practice Address - Phone:409-896-5000
Practice Address - Fax:409-896-5926
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1337207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP082Z1114Medicaid
TX82Z111Medicare ID - Type Unspecified
TXP082Z1114Medicaid