Individual
DR. BRET BEAVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2901 ACME BRICK PLZ, FORT WORTH, TX 76109-4124
(817) 529-1900
(817) 529-1910
Mailing address
2901 ACME BRICK PLZ, FORT WORTH, TX 76109-4124
(817) 529-1900
(817) 529-1910
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
P1268
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
349173001
—
TX
01
—
8EF802
BCBS
TX
01
—
P01833801
MEDICARE RAILROAD
TX
Enumeration date
04/11/2012
Last updated
10/08/2020
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