Individual
DR. JOHN WESLEY BEATY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1701 N COLLINS BLVD, SUITE 230, RICHARDSON, TX 75080-3553
(972) 596-6351
(972) 231-4886
Mailing address
1701 N COLLINS BLVD, SUITE 230, RICHARDSON, TX 75080-3553
(972) 596-6351
(972) 231-4886
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
22958
TX
103TC1900X
Counseling Psychologist
Primary
22958
TX
103TF0200X
Forensic Psychologist
22958
TX
103TS0200X
School Psychologist
30315
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004225322
AETNA BEHAVIORAL HEALTH
TX
01
—
082142000
MAGELLAN HEALTH SERVICES
TX
01
—
140051
VALUE OPTIONS
TX
Enumeration date
01/05/2007
Last updated
11/10/2010
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