Organization
BETAMED, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA DAVID SHIELDS C.P.A. (CEO)
(979) 703-1407
Entity
Organization
Contact information
Practice address
1802 WELSH AVE, COLLEGE STATION, TX 77840-4851
(979) 703-1407
(979) 703-1403
Mailing address
1802 WELSH AVE, COLLEGE STATION, TX 77840-4851
(979) 703-1407
(979) 703-1403
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0061609
TX
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149290201
—
TX
05
—
149290202
—
TX
01
—
280439
SCOTT & WHITE HEALTH PLAN
TX
05
—
4293300001
—
TX
01
—
531128
BLUECROSS BLUESHIELD TX
TX
01
—
AETNA
7407334
TX
Enumeration date
03/01/2006
Last updated
11/13/2020
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