Beaudry, Carl Joseph
Beaudry, Carl Joseph is an sole proprietor health care provider with primary practice located at 2501 Jimmy Johnson Blvd Suite 202, Port Arthur TX 77640-2007. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Beaudry, Carl Joseph can be contacted via phone (409) 722-4446.Contact Information
Primary practice address
2501 Jimmy Johnson Blvd Suite 202
Port Arthur TX 77640-2007
Phone: (409) 722-4446
Fax: (409) 722-4448
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | E9531 | Texas |
Profile Details
| NPI number | 1750338380 |
|---|---|
| LBN Legal business name | Beaudry, Carl Joseph |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 28th, 2006 |
| Last updated | Mar 7th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750338380 | NPPES |
| Texas | MEDICAID | 097777901 | |
| Texas | Other | E9531 | |
| Texas | Other | 687562 | |
| Texas | Other | CIGNA | |
| Texas | Other | 0082GS | |
| Texas | Other | S0033018 |
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