Provider Demographics
NPI:1578604914
Name:FAMILY PRACTICE AND SPECIALTY ASSOCIATES OF BEEVILLE PLLC
Entity Type:Organization
Organization Name:FAMILY PRACTICE AND SPECIALTY ASSOCIATES OF BEEVILLE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:DEHNISCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-362-3648
Mailing Address - Street 1:210 E CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:BEEVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78102-4810
Mailing Address - Country:US
Mailing Address - Phone:361-362-3648
Mailing Address - Fax:
Practice Address - Street 1:600 S HILLSIDE DR
Practice Address - Street 2:
Practice Address - City:BEEVILLE
Practice Address - State:TX
Practice Address - Zip Code:78102-5327
Practice Address - Country:US
Practice Address - Phone:361-362-3648
Practice Address - Fax:361-572-8518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X
TX207RI0200X, 207RN0300X, 207RP1001X, 208000000X, 208D00000X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX158514301Medicaid
TX158514301Medicaid
TX00989UMedicare PIN