Individual
JOHN ANDREW BEVERLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
211 HIGHLAND CROSS DR STE 275, HOUSTON, TX 77073-1741
(281) 784-3203
Mailing address
2138 FENWOOD ST, KEMAH, TX 77565-2116
(713) 922-4482
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA08033
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1700138799
TRICARE
TX
05
—
313597201
—
TX
05
—
313597202
—
TX
01
—
760555765
UNITED HEALTH CARE
TX
01
—
890N67
BLUE CROSS BLUE SHIELD OF TEXAS
TX
Enumeration date
10/15/2012
Last updated
05/13/2013
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