Individual
DR. PAUL DWIGHT BEERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MDD4029
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00ET77
BCBS
TX
05
—
033047401
—
TX
01
—
15654
AMERIGROUP
TX
01
—
826302203A
PALMETTO
TX
01
—
MDD4029
LIC NUMBER
TX
Enumeration date
12/21/2006
Last updated
02/19/2014
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