Provider Demographics
NPI:1609890367
Name:BEASLEY, KAROLE L (MD)
Entity Type:Individual
Prefix:DR
First Name:KAROLE
Middle Name:L
Last Name:BEASLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1602 E HOUSTON ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:BEEVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78102-5326
Mailing Address - Country:US
Mailing Address - Phone:361-358-9200
Mailing Address - Fax:361-362-1717
Practice Address - Street 1:1602 E HOUSTON ST
Practice Address - Street 2:SUITE C
Practice Address - City:BEEVILLE
Practice Address - State:TX
Practice Address - Zip Code:78102-5326
Practice Address - Country:US
Practice Address - Phone:361-358-9200
Practice Address - Fax:361-362-1717
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG1256207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX128579303Medicaid
TX128579307Medicaid
TX128579303Medicaid
TX128579307Medicaid
TX89017BMedicare PIN