MEDICARE: DR. JOHN DAVID BEERBOWER 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	174400000X	Specialist	F9183	TX
2	2085N0700X	Neuroradiology Physician	F9183	TX
3	2085R0204X	Vascular & Interventional Radiology Physician	F9183	TX
4	208VP0014X	Interventional Pain Medicine Physician	F9183	TX
5	208VP0000X	Pain Medicine Physician	F9183	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

General Provider Information

NPI Number	:	1811989577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN DAVID BEERBOWER MD

Provider Business Mailing Address
First Line	:	3692 E SAM HOUSTON PKWY S
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77505-3102
Country	:	US
Telephone Number	:	281-487-6736
Fax Number	:	281-487-1766

Provider Business Practice Location Address
First Line	:	3692 E SAM HOUSTON PKWY S
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77505-3102
Country	:	US
Telephone Number	:	281-487-6736
Fax Number	:	281-487-1766

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

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	12/01/2014

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