Active NPI
Justin Casey Beard, PA
- Physician Assistant
- Dallas, TX
National Provider Identifier
1164687828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA05709
- Practice address
- 8616 Greenville Ave Ste 100
Dallas, TX 75243-7166 - Phone
- (214) 272-9710
- Fax
- (214) 272-9709
- NPI assigned
- Jul 22, 2008
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA05709 | TX | Primary |
Addresses
Primary practice location
8616 Greenville Ave Ste 100
Dallas, TX 75243-7166
Mailing address
8616 Greenville Ave Ste 100
Dallas, TX 75243-7166
Phone (214) 272-9710
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA05709 | TX | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225238400000",
"number": "1164687828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8616 GREENVILLE AVE STE 100",
"city": "DALLAS",
"state": "TX",
"postal_code": "752437166",
"telephone_number": "214-272-9710",
"fax_number": "214-272-9709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8616 GREENVILLE AVE STE 100",
"city": "DALLAS",
"state": "TX",
"postal_code": "752437166",
"telephone_number": "214-272-9710",
"fax_number": "214-272-9709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEARD",
"first_name": "JUSTIN",
"middle_name": "CASEY",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-22",
"last_updated": "2008-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA05709",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.