Active NPI
Ronald David Beals, M.D.
- Family Medicine Physician
- Tyler, TX
National Provider Identifier
1114206455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- H1552
- Practice address
- 9030 Old Hickory Rd
Tyler, TX 75703-7651 - Phone
- (903) 561-6274
- Fax
- (903) 561-6274
- NPI assigned
- Aug 4, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | H1552 | TX | Primary |
Addresses
Primary practice location
9030 Old Hickory Rd
Tyler, TX 75703-7651
Mailing address
9030 Old Hickory Rd
Tyler, TX 75703-7651
Phone (903) 561-6274
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H1552 | TX | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312416000000",
"number": "1114206455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9030 OLD HICKORY RD",
"city": "TYLER",
"state": "TX",
"postal_code": "757037651",
"telephone_number": "903-561-6274",
"fax_number": "903-561-6274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9030 OLD HICKORY RD",
"city": "TYLER",
"state": "TX",
"postal_code": "757037651",
"telephone_number": "903-561-6274",
"fax_number": "903-561-6274"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEALS",
"first_name": "RONALD",
"middle_name": "DAVID",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-08-04",
"last_updated": "2011-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "H1552",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.