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General NPI Number Information
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NPI Number | 1700933116
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Entity Type | Organization
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Legal Business Name | JOHN W. BEATY, PH.D.,P.C.
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1701 N COLLINS BLVD SUITE 210
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City | RICHARDSON
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State | TX
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Zip | 75080-3564
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Country | US
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Telephone | 972-596-6351
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Fax | 972-231-4886
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Provider Business Mailing Address
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Address Line | 1701 N COLLINS BLVD SUITE 210
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City | RICHARDSON
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State | TX
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Zip | 75080-3564
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Country | US
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Telephone | 972-596-6351
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Fax | 972-231-4886
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN WESLEY BEATY
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Credential | PH.D.
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Telephone | 972-596-6351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 22958
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | 22958
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 30315
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number | 22958
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 22958
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number | 22958
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License Number State | TX
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