Individual
DR. CHARLES V BEALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
910 E HOUSTON ST, SUITE 550, TYLER, TX 75702-8369
(903) 592-7393
(903) 597-7538
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6450
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
H6039
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
099323002
—
TX
01
—
122995
SUPERIOR/CHIPS
TX
01
—
4523320
AETNA
TX
01
—
83Y705
BCBS
TX
Enumeration date
01/26/2006
Last updated
12/08/2014
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