Provider Demographics
NPI:1710901764
Name:BEARD, ROBERT H (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:H
Last Name:BEARD
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 1:12200 PRESTON RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2223
Mailing Address - Country:US
Mailing Address - Phone:972-560-2667
Mailing Address - Fax:972-239-6649
Practice Address - Street 1:12200 PRESTON RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2223
Practice Address - Country:US
Practice Address - Phone:972-560-2667
Practice Address - Fax:972-239-6649
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9726207R00000X, 208000000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CZ841OtherBCBSTX
TX8A0781OtherBCBS
TX8916M1Medicare PIN
TX110224939Medicare PIN
TX8CZ841OtherBCBSTX
TXH42220Medicare UPIN
TX145171804Medicaid
TX110224939Medicare PIN