Provider Demographics
NPI:1134225782
Name:BEEVILLE MEDICAL ASSOCIATES, PLLC
Entity type:Organization
Organization Name:BEEVILLE MEDICAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:R
Authorized Official - Last Name:DEHNISCH
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:361-358-9200
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG1256207Q00000X
TXM2475207RI0200X, 207RP1001X
TXM2669207RN0300X
TXM2233208000000X
TXE9576208D00000X
TX1195213E00000X
TXD8190207Q00000X
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
TX0044AZMedicare ID - Type UnspecifiedGROUP BMA
TXI50821Medicare UPIN
TXI22114Medicare UPIN
TXE09238Medicare UPIN
TXI46428Medicare UPIN
TXB22192Medicare UPIN
TXC14444Medicare UPIN
TXU30920Medicare UPIN