Organization
BEAU MCCRORY MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN SOWDER CPC, CCP (CHIEF OPERATIONS OFFICER)
(940) 384-6238
Entity
Organization
Contact information
Practice address
105 VALLEY FORGE ST, COMANCHE, TX 76442-1813
(325) 356-7530
(940) 382-7680
Mailing address
PO BOX 2023, DENTON, TX 76202-2023
(940) 384-6238
(940) 382-7680
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0093JV
BLUE CROSS BLUE SHIELD
TX
Enumeration date
04/25/2006
Last updated
08/22/2020
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