MEDICARE: DAVID H BEAIRD MD

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	207R00000X	Internal Medicine Physician	H2235	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	122994	OTHER	TX	SUPERIOR/CHIPS
2	TAX ID AND 035	OTHER	TX	TRICARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	4521776	OTHER	TX	AETNA
5	83Y723	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1316917750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID H BEAIRD MD

Provider Business Mailing Address
First Line	:	PO BOX 846098
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-6098
Country	:	US
Telephone Number	:	903-324-6450
Fax Number	:

Provider Business Practice Location Address
First Line	:	520 E DOUGLAS BLVD
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75702-8307
Country	:	US
Telephone Number	:	903-593-1721
Fax Number	:	903-510-1143

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

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	12/08/2014

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Directions to “ DAVID H BEAIRD MD” Practice Location

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