Provider Demographics
NPI:1225398522
Name:BESHARA, PETER ADEL (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:ADEL
Last Name:BESHARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10121 EMMETT F LOWRY EXPY
Mailing Address - Street 2:
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77591-2286
Mailing Address - Country:US
Mailing Address - Phone:409-986-9686
Mailing Address - Fax:409-986-7890
Practice Address - Street 1:10121 EMMETT F LOWRY EXPY
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-2286
Practice Address - Country:US
Practice Address - Phone:409-986-9686
Practice Address - Fax:409-986-7890
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10043351207Q00000X
TXQ2738207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine