MEDICARE: DR. KENNETH ALLEN BEIL 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	2085R0202X	Diagnostic Radiology Physician	K3681	TX

General Provider Information

NPI Number	:	1568459634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH ALLEN BEIL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 30283
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78755-3283
Country	:	US
Telephone Number	:	866-640-4141
Fax Number	:	877-787-4712

Provider Business Practice Location Address
First Line	:	2852 GRIMES RANCH RD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78732-2016
Country	:	US
Telephone Number	:	866-640-4141
Fax Number	:	877-787-4712

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

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	07/09/2007

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