Provider Demographics
NPI:1477544211
Name:HELD, BEVERLY L (MD)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:L
Last Name:HELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DERMATOLOGY
Other - Middle Name:ASSOCIATES
Other - Last Name:INC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5756 S STAPLES ST
Mailing Address - Street 2:SUITE J-2
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-3782
Mailing Address - Country:US
Mailing Address - Phone:361-993-3192
Mailing Address - Fax:361-993-3800
Practice Address - Street 1:5756 S STAPLES ST
Practice Address - Street 2:SUITE J-2
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-3782
Practice Address - Country:US
Practice Address - Phone:361-993-3192
Practice Address - Fax:361-993-3800
Is Sole Proprietor?:No
Enumeration Date:2005-11-01
Last Update Date:2010-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD4148174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX071900011OtherMEDICARE RAILROAD
TXD4148OtherTEXAS MEDICAL LICENSE #
TX00N148OtherMEDICARE PROVIDER #
TX00N148OtherMEDICARE PROVIDER #