Provider Demographics
NPI:1144620600
Name:BEUTEL, DANIEL DON (CSFA)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:DON
Last Name:BEUTEL
Suffix:
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 NW ACCESS RD
Mailing Address - Street 2:
Mailing Address - City:IOWA PARK
Mailing Address - State:TX
Mailing Address - Zip Code:76367-3009
Mailing Address - Country:US
Mailing Address - Phone:940-781-9342
Mailing Address - Fax:
Practice Address - Street 1:1900 NW ACCESS RD
Practice Address - Street 2:
Practice Address - City:IOWA PARK
Practice Address - State:TX
Practice Address - Zip Code:76367-3009
Practice Address - Country:US
Practice Address - Phone:940-781-9342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-02
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX143921246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant