Provider Demographics
NPI:1528037512
Name:BEAVER, RICHARD LEIGH (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:LEIGH
Last Name:BEAVER
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 1:10125 KATY FWY STE 100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1287
Mailing Address - Country:US
Mailing Address - Phone:713-486-1700
Mailing Address - Fax:713-467-6775
Practice Address - Street 1:10125 KATY FWY STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1287
Practice Address - Country:US
Practice Address - Phone:713-486-1700
Practice Address - Fax:713-467-6775
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9094207X00000X, 207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AD234OtherBCBS
TX212102201Medicaid
TX5978718OtherAETNA
TXP00824674OtherRAILROAD MEDICARE
TX8L24427Medicare PIN