1255344420 NPI number — MR. BRETT ALLAN BEUNING D.P.T.

Table of content: MR. BRETT ALLAN BEUNING D.P.T. (NPI 1255344420)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255344420 NPI number — MR. BRETT ALLAN BEUNING D.P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BEUNING
Provider First Name:
BRETT
Provider Middle Name:
ALLAN
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
D.P.T.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255344420
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/18/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17325 BELL NORTH DR
Provider Second Line Business Mailing Address:
SUITE 2-B.
Provider Business Mailing Address City Name:
SCHERTZ
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78154-3368
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-590-4002
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1324 COMMON ST
Provider Second Line Business Practice Location Address:
STE 307
Provider Business Practice Location Address City Name:
NEW BRAUNFELS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78130-3565
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-625-7310
Provider Business Practice Location Address Fax Number:
830-625-3228
Provider Enumeration Date:
08/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208100000X , with the licence number:  9278 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: 1231450 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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