Individual
DR. PAUL DWIGHT BEERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
713 E ANDERSON ST, WEATHERFORD, TX 76086-5705
(817) 596-8751
(817) 599-1441
Mailing address
PO BOX 490, WEATHERFORD, TX 76086-0490
(817) 738-2000
(817) 738-2224
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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