Bestawrous Family Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

K3989 Issued in TX

Legal business name

BESTAWROUS FAMILY CLINIC

Practice address

1200 Keller Pkwy
100
Keller, TX 76248

Phone

(817) 741-8011

Fax

(817) 741-8005

NPI assigned

Feb 12, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Reda S Bestawrous, MDNPI 1811995723

Title

Owner Physician

Phone

(817) 741-8011

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Reda Saber Bestawrous, M.D.

  • Family Medicine Physician
  • Watauga, TX
  • NPI 1811995723

  Family Medicine, TX

  Medicare reassignment NPD Authorized official
• Michelle Lee Ballou

  • Family Nurse Practitioner
  • Keller, TX
  • NPI 1023853603
  NPD
• Lakshmi P Gujju, MD

  • Family Medicine Physician
  • Euless, TX
  • NPI 1497974026

  Family Medicine

  NPD (past)
• Amanda Kaye Pittsley, FNP

  • Family Nurse Practitioner
  • Lone Tree, CO
  • NPI 1699240903

  Multi-Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230076800000",
    "number": "1265600308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 KELLER PKWY",
            "address_2": "SUITE 100",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "76248",
            "telephone_number": "817-741-8011",
            "fax_number": "817-741-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 KELLER PKWY",
            "address_2": "100",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "76248",
            "telephone_number": "817-741-8011",
            "fax_number": "817-741-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BESTAWROUS FAMILY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-12",
        "last_updated": "2008-12-24",
        "status": "A",
        "authorized_official_last_name": "BESTAWROUS",
        "authorized_official_first_name": "REDA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "817-741-8011",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K3989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8X1830",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mariah Bermejo
• Elit Januras Bernales-Alba, ARNP
• Valarie A. Bernier, APRN-CNP, FNP-BC
• Alexia Berreondo
• Kayrene K Berry, LPC
• Sara Beyene
• Neerav Jay Bhatla, M.D.
• Gina Anthony Biedermann, D.D.S.
• Diana Bigham, M.A.
• Bill Burke, DO a Professional Association

• All providers in Keller, TX
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.