Basic Information
| Provider Information | |||||||||
| NPI: | 1891825469 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ROBERT E BEESON MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1075 KINGWOOD DR | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | KINGWOOD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773393006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2813588114 | ||||||||
| FaxNumber: | 2813580609 | ||||||||
| Practice Location | |||||||||
| Address1: | 4201 GARTH RD | ||||||||
| Address2: | SUITE 212 | ||||||||
| City: | BAYTOWN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775213167 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814209355 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2007 | ||||||||
| LastUpdateDate: | 06/21/2011 | ||||||||
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| AuthorizedOfficialLastName: | BEESON | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7133069699 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | J3279 | TX | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207L00000X | J3279 | TX | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 0066PL | 01 | TX | BCBS | OTHER | 614367800 | 01 | TX | DEPARTMENT OF LABOR | OTHER | 191796501 | 05 | TX | MEDICAID | DG0945 | 01 | TX | RAILROAD MEDICARE | OTHER |