Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | K0263 | TX |
NPI | 1003846445 |
---|---|
Provider Name | Dr. Eric D Beshires |
First Address | Garland, TX 75040-2767 |
Second Address | Garland, TX 75040-2767 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 29/07/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
080120301 | RR MEDICARE (01) | TX |
101692502 | (05) | TX |
86100G | BCBS (01) | TX |
G56053 | (02) | TX |