Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 34563 | TX |
N | 1223X0400X | Orthodontists | 8727 | CO |
NPI | 1063532570 |
---|---|
Provider Name | Dr. William D Beaber |
First Address | Heath, TX 75032-6224 |
Second Address | Heath, TX 75032-6224 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 05/02/2020 |