Provider Demographics
NPI:1558367037
Name:BEAUDOING, DENIS L (MD)
Entity Type:Individual
Prefix:
First Name:DENIS
Middle Name:L
Last Name:BEAUDOING
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 1:8226 DOUGLAS AVE
Mailing Address - Street 2:STE 540
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-5927
Mailing Address - Country:US
Mailing Address - Phone:214-692-7447
Mailing Address - Fax:214-692-7110
Practice Address - Street 1:8226 DOUGLAS AVE
Practice Address - Street 2:STE 540
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5927
Practice Address - Country:US
Practice Address - Phone:214-692-7447
Practice Address - Fax:214-692-7110
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-21
Last Update Date:2007-07-08
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-04-05
Provider Licenses
StateLicense IDTaxonomies
TXE9529207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology