Healthcare Provider Details

I. General information

NPI: 1578604914
Provider Name (Legal Business Name): FAMILY PRACTICE AND SPECIALTY ASSOCIATES OF BEEVILLE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 07/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S HILLSIDE DR
BEEVILLE TX
78102-5327
US

IV. Provider business mailing address

210 E CLEVELAND ST
BEEVILLE TX
78102-4810
US

V. Phone/Fax

Practice location:
  • Phone: 361-362-3648
  • Fax: 361-572-8518
Mailing address:
  • Phone: 361-362-3648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice 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 Code213E00000X
TaxonomyPodiatrist
License Number
License Number StateTX
# 7
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: FRANK DEHNISCH
Title or Position: DIRECTOR
Credential: MD
Phone: 361-362-3648