MEDICARE: DR. THOMAS P BEVERIDGE M.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
1	207RC0001X	Clinical Cardiac Electrophysiology Physician	K0640	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396712840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS P BEVERIDGE M.D.

Provider Business Mailing Address
First Line	:	1820 PRESTON PARK BLVD
Second Line	:	# 1450
City	:	PLANO
State	:	TX
Zip	:	75093-3656
Country	:	US
Telephone Number	:	469-800-4540
Fax Number	:

Provider Business Practice Location Address
First Line	:	1820 PRESTON PARK BLVD
Second Line	:	# 1450
City	:	PLANO
State	:	TX
Zip	:	75093-3656
Country	:	US
Telephone Number	:	469-800-4540
Fax Number	:

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

Provider Enumeration Date	:	03/03/2006
Last Update Date	:	03/28/2022

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