MEDICARE: MRS. CARRIE STEPHANIE BEATTY 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	208000000X	Pediatrics Physician	K0258	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	1265475891	OTHER	TX	GROUP NPI

General Provider Information

NPI Number	:	1629011242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CARRIE STEPHANIE BEATTY M.D.

Provider Business Mailing Address
First Line	:	333 N SANTA ROSA ST
Second Line	:	SUITE D4023
City	:	SAN ANTONIO
State	:	TX
Zip	:	78207-3108
Country	:	US
Telephone Number	:	469-282-2711
Fax Number	:	469-282-2609

Provider Business Practice Location Address
First Line	:	1434 E SONTERRA BLVD STE 105
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4972
Country	:	US
Telephone Number	:	210-479-3000
Fax Number	:	210-479-3016

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

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	03/18/2019

Similar Medicare Providers

1881914000 — GRUPO MEDICO POLICLINICA SAN PEDRO MEDICARE ADVANTAGE
Practice Location Address:

211 CALLE MORSE
ARROYO, PR
00714-2350

Practice Phone: 787-839-3980
Practice Fax: 787-271-2515

1780627919 — MRS. MIRIAM CANTU BAUER M.D.
Practice Location Address:

1434 E SONTERRA BLVD STE 105
SAN ANTONIO, TX
78258-4972

Practice Phone: 210-479-3000
Practice Fax: 210-479-3016

1194907683 — DR. RENEE M. HENIGAN MD
Practice Location Address:

1434 E SONTERRA BLVD STE 109
SAN ANTONIO, TX
78258-4972

Practice Phone: 210-479-3000
Practice Fax: 210-479-3016

1386928562 — DR. SHAHED IZADDOOST MD
Practice Location Address:

1434 E SONTERRA BLVD STE 109
SAN ANTONIO, TX
78258-4972

Practice Phone: 210-479-3000
Practice Fax: 210-479-3016

1922482215 — LEAH COLLAZO
Practice Location Address:

8405 ECHO CREEK LN
SAN ANTONIO, TX
78240-4972

Practice Phone: 210-632-5640
Practice Fax:

1700096617 — DR. EMILIO VISEY VISTA D.M.D.
Practice Location Address:

4972 MISSION ST
SAN FRANCISCO, CA
94112-3416

Practice Phone: 415-333-3400
Practice Fax:

Directions to “ MRS. CARRIE STEPHANIE BEATTY M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.