Active NPI
Gabriel Beidoe, DR
- Pharmacist
- San Angelo, TX
National Provider Identifier
1316542947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 51078
- Practice address
- 4210 College Hills Blvd
San Angelo, TX 76904-6509 - Phone
- (325) 942-8602
- NPI assigned
- Dec 1, 2020
- Last updated
- Dec 1, 2020
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 51078 | TX | Primary |
Addresses
Primary practice location
4210 College Hills Blvd
San Angelo, TX 76904-6509
Mailing address
1918 Pine Valley St
San Angelo, TX 76904-1712
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606780800000",
"number": "1316542947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1918 PINE VALLEY ST",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "769041712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4210 COLLEGE HILLS BLVD",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "769046509",
"telephone_number": "325-942-8602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEIDOE",
"first_name": "GABRIEL",
"credential": "DR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-01",
"last_updated": "2020-12-01",
"certification_date": "2020-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "51078",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Angelo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.