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NPI Code Detail

MEDICARE: DR. ANGELA GERMAINE BEVELS O.D.

MEDICARE: DR. ANGELA GERMAINE BEVELS O.D.
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
1152W00000XOptometrist1328AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
229839OTHERAZAVESIS
32Z2034OTHERAZHEALTH NET

General Provider Information

NPI Number : 1073588703
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANGELA GERMAINE BEVELS O.D.
Provider Business Mailing Address
First Line : 3402 E BROADWAY BLVD
Second Line :
City : TUCSON
State : AZ
Zip : 85716-5406
Country : US
Telephone Number : 520-355-2060
Fax Number :
Provider Business Practice Location Address
First Line : 3402 E BROADWAY BLVD
Second Line :
City : TUCSON
State : AZ
Zip : 85716-5406
Country : US
Telephone Number : 203-552-0605
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2006
Last Update Date : 03/14/2023

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