Organization
JOHN R. BEAUCHAMP M.D., P.A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN ROBERT BEAUCHAMP M.D. P.A (DOCTOR)
(210) 824-7938
Entity
Organization
Contact information
Practice address
7959 BROADWAY ST, SUITE 604, SAN ANTONIO, TX 78209-2667
(210) 824-7938
(210) 805-9523
Mailing address
7959 BROADWAY ST, SUITE 604, SAN ANTONIO, TX 78209-2667
(210) 824-7938
(210) 805-9523
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
D1544
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00J913
BLUE CROSS/BLUE SHIELD
TX
01
—
4259770
AETNA NUMBER
TX
Enumeration date
08/23/2006
Last updated
08/22/2020
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