Organization
CARL J BEAUDRY, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANNA LAREE TREJO (PRACTICE MANAGER)
(409) 722-4446
Entity
Organization
Contact information
Practice address
2501 JIMMY JOHNSON BLVD STE 202, PORT ARTHUR, TX 77640-2009
(409) 722-4446
(409) 722-4448
Mailing address
2501 JIMMY JOHNSON BLVD STE 202, PORT ARTHUR, TX 77640-2009
(409) 722-4446
(409) 722-4448
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
E9531
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8B7430
BCBS GROUP
TX
Enumeration date
08/14/2007
Last updated
08/14/2007
Update your record
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