Healthcare Provider Details

I. General information

NPI: 1740315712
Provider Name (Legal Business Name): BEEVILLE MEDICAL ASSOICATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 06/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1602 E HOUSTON ST STE C
BEEVILLE TX
78104-0100
US

IV. Provider business mailing address

PO BOX 1233
KINGSVILLE TX
78364-1233
US

V. Phone/Fax

Practice location:
  • Phone: 361-358-9200
  • Fax: 361-358-5513
Mailing address:
  • Phone: 361-358-9200
  • Fax: 361-358-5513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateTX
# 6
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateTX
# 7
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number StateTX
# 8
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number07023267
License Number StateTX

VIII. Authorized Official

Name: MRS. ESTHER MARTINEZ
Title or Position: HR DIVISION MANAGER
Credential:
Phone: 361-358-9200