MEDICARE: DAVID M. BEYER, D.O., P.A.

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	207Q00000X	Family Medicine Physician	D5350	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	D5350	OTHER	TX	STATE MEDICAL LICENSE

General Provider Information

NPI Number	:	1811958119
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID M. BEYER, D.O., P.A.

Provider Business Mailing Address
First Line	:	4201 CAMP BOWIE BLVD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-3928
Country	:	US
Telephone Number	:	817-731-0801
Fax Number	:	817-731-8468

Provider Business Practice Location Address
First Line	:	4201 CAMP BOWIE BLVD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-3928
Country	:	US
Telephone Number	:	817-731-0801
Fax Number	:	817-731-8468

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DAVID M BEYER
Credential	:	D.O.
Telephone Number	:	817-731-0801

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	08/22/2020

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