MEDICARE: MS. BEVERLEY JEAN SPRINGSTEAD P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	03750	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154367159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BEVERLEY JEAN SPRINGSTEAD P.A.

Provider Business Mailing Address
First Line	:	618 N JEFFERSON AVE
Second Line	:	SUITE 1
City	:	MT PLEASANT
State	:	TX
Zip	:	75455-3647
Country	:	US
Telephone Number	:	903-575-9500
Fax Number	:	903-575-9866

Provider Business Practice Location Address
First Line	:	618 N JEFFERSON AVE
Second Line	:	SUITE 1
City	:	MT PLEASANT
State	:	TX
Zip	:	75455-3647
Country	:	US
Telephone Number	:	903-575-9500
Fax Number	:	903-575-9866

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	01/29/2010

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Directions to “ MS. BEVERLEY JEAN SPRINGSTEAD P.A.” Practice Location

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