Provider Demographics
NPI:1497785554
Name:BEAMER, MONICA J (MD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:J
Last Name:BEAMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-1860
Mailing Address - Fax:682-885-1396
Practice Address - Street 1:4443 N JOSEY LN STE 150
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4680
Practice Address - Country:US
Practice Address - Phone:972-820-7595
Practice Address - Fax:972-820-7549
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ6358208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX109379104Medicaid
TX081500301Medicaid
TX8L5123Medicare PIN
TX081500301Medicaid
TXG38712Medicare UPIN
TX8D7839Medicare PIN