MR. CARL JOSEPH BEAUDRY M.D. NPI 1750338380

NPI Information

NPI: 1750338380
Provider Name: MR. CARL JOSEPH BEAUDRY, M.D.
Classification: Specialist - 174400000X
Entity Type: Individual
Address:
2501 JIMMY JOHNSON BLVD
SUITE 202
PORT ARTHUR, TX
ZIP 77640
Phone: (409) 722-4446
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MR. Carl Joseph Beaudry, M.D. is a specialist in Port Arthur, TX. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MR. Carl Joseph Beaudry, M.D. NPI is 1750338380. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2501 JIMMY JOHNSON BLVD
SUITE 202
PORT ARTHUR, TX
ZIP 77640-007
Phone: (409) 722-4446
Fax: (409) 722-4448

The enumeration date for this NPI number is 5/28/2006 and was last updated on 3/7/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		E9531	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	097777901	MEDICAID	TEXAS
2	E9531	OTHER	TEXAS	PHYSICIAN PERMIT
3	687562	OTHER	TEXAS	AETNA
4	CIGNA	OTHER	TEXAS	3739015001
5	0082GS	OTHER	TEXAS	BLUE CROSS
6	S0033018	OTHER	TEXAS	DPS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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