Provider Demographics
NPI:1003146184
Name:BEADLE, CLAIRE LELEUX (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:CLAIRE
Middle Name:LELEUX
Last Name:BEADLE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7703 FLOYD CURL DR
Mailing Address - Street 2:MC7977
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:210-450-9000
Mailing Address - Fax:
Practice Address - Street 1:4502 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4402
Practice Address - Country:US
Practice Address - Phone:210-358-4000
Practice Address - Fax:210-358-4911
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX704341367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX211047001Medicaid
TX211047002Medicaid
TX8047UAOtherBLUE CROSS BLUE SHIELD
TX211047003Medicaid
TXP00911599OtherRAILROAD MEDICARE
TX211047003Medicaid
TX8L26385Medicare PIN