Individual
CHADWICK DALE BEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACNP
Contact information
Practice address
3601 21ST ST, LUBBOCK, TX 79410-1229
(806) 791-0399
(806) 791-0373
Mailing address
2215 NASHVILLE AVE, LUBBOCK, TX 79410-1105
(806) 725-5844
(806) 723-6532
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP118578
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
308679503
—
TX
01
—
335111YKT8
MEDICARE
TX
01
—
8295NS
BCBS
TX
Enumeration date
12/21/2009
Last updated
01/20/2022
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