Individual
DR. ANTHONY BRET BEAVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 N HIGHLAND AVE, SHERMAN, TX 75092-7354
(972) 870-4205
Mailing address
4708 CANVASBACK BLVD, MCKINNEY, TX 75070-9034
(972) 562-8053
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
J9966
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134272708
—
TX
05
—
134272710
—
TX
05
—
134272711
—
TX
05
—
134272714
—
TX
01
—
8A0477
BCBS
TX
01
—
8M6697
BLUE CROSS BLUE SHIELD
TX
01
—
8S9031
BLUE CROSS BLUE SHIELD
TX
01
—
930102137
MEDICARE RAILROAD
TX
01
—
P00198884
RAIL ROAD MEDICARE
TX
Enumeration date
12/13/2005
Last updated
12/21/2010
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