Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | K3101 | TX |
NPI | 1003901703 |
---|---|
Provider Name | Dr. Beverly Brown Bishop |
First Address | Cedar Hill, TX 75104-3507 |
Second Address | Cedar Hill, TX 75104-3507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 07/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0016DQ | BCBS GROUP (01) | TX |
0898808 | AETNA HMO (01) | |
0898808 | AETNA POS (01) | |
122177205 | (05) | TX |
122177206 | (05) | TX |
180028816 | MEDICARE RR DALLAS COUNTY (01) | TX |
180034452 | MEDICARE RR ELLIS COUNTY (01) | TX |
4146505 | BCBD BLUE LINK (01) | |
5248549 | AETNA PPO (01) | |
86772X | BCBS PROVIDER ID (01) | TX |
G46505 | (02) | TX |
UNITED HEALTHCARE | 751622524 (01) |