Organization
DOMINIQUE J BEAUDRY MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOMINIQUE J BEAUDRY MD (MD/OWNER)
(409) 899-2121
Entity
Organization
Contact information
Practice address
3030 NORTH ST, SUITE 312, BEAUMONT, TX 77702-1433
(409) 899-2020
(409) 899-2121
Mailing address
3030 NORTH ST, SUITE 312, BEAUMONT, TX 77702-1433
(409) 899-2020
(409) 899-2121
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
M9151
TX
207RI0011X
Interventional Cardiology Physician
Primary
M9151
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197371102
—
TX
Enumeration date
07/10/2008
Last updated
09/23/2011
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