MEDICARE: RACHEL-LOUISE BEDDARD 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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	0101233736	VA

General Provider Information

NPI Number	:	1467473520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL-LOUISE BEDDARD MD

Provider Business Mailing Address
First Line	:	22420 FOSSIL PATH
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78261-2630
Country	:	US
Telephone Number	:	210-272-0708
Fax Number	:

Provider Business Practice Location Address
First Line	:	22420 FOSSIL PATH
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78261-2630
Country	:	US
Telephone Number	:	210-272-0708
Fax Number	:

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

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	12/07/2010

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