Provider Demographics
NPI:1093185381
Name:BEASLEY, ESTER (CRNA)
Entity Type:Individual
Prefix:
First Name:ESTER
Middle Name:
Last Name:BEASLEY
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 1:1985 1ST ST W UNIT 2263
Mailing Address - Street 2:
Mailing Address - City:JBSA RANDOLPH
Mailing Address - State:TX
Mailing Address - Zip Code:78150-4345
Mailing Address - Country:US
Mailing Address - Phone:434-806-5538
Mailing Address - Fax:
Practice Address - Street 1:400 CONCORD PLAZA DR STE 300
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-6991
Practice Address - Country:US
Practice Address - Phone:210-804-5400
Practice Address - Fax:210-678-4142
Is Sole Proprietor?:No
Enumeration Date:2015-09-30
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20272367500000X
VA0024174943367500000X
TX1093380367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered