MEDICARE: JONAS ALEXANDER BEYENE 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	207P00000X	Emergency Medicine Physician	R8866	TX
2	2084P0800X	Psychiatry Physician	R8866	TX

General Provider Information

NPI Number	:	1770015968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONAS ALEXANDER BEYENE M.D.

Provider Business Mailing Address
First Line	:	669 AIRPORT FWY STE 401
Second Line	:
City	:	HURST
State	:	TX
Zip	:	76053-3964
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	669 AIRPORT FWY STE 401
Second Line	:
City	:	HURST
State	:	TX
Zip	:	76053-3964
Country	:	US
Telephone Number	:	972-332-5922
Fax Number	:

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

Provider Enumeration Date	:	03/28/2017
Last Update Date	:	04/08/2026

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