Individual
ANDREA C BEAVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6181 BONNIE VIEW RD STE 160, DALLAS, TX 75241-5149
(214) 374-0827
(214) 374-0927
Mailing address
6181 BONNIE VIEW RD STE 160, DALLAS, TX 75241-5149
(214) 374-0827
(214) 374-0927
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA06332
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205082501
—
TX
05
—
205082502
—
TX
05
—
205082503
—
TX
Enumeration date
07/21/2009
Last updated
01/17/2024
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