Provider Demographics
NPI:1447887682
Name:CHIMENE, BEVERLY (MD)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:
Last Name:CHIMENE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 183A
Mailing Address - Street 2:SUITE R100
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613
Mailing Address - Country:US
Mailing Address - Phone:512-595-7000
Mailing Address - Fax:
Practice Address - Street 1:5001 183A
Practice Address - Street 2:SUITE R100
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613
Practice Address - Country:US
Practice Address - Phone:512-595-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU7844207Q00000X
IL125075816390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine