Dominique J Beaudry MD PA

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

M9151 Issued in TX

Legal business name

DOMINIQUE J BEAUDRY MD PA

Practice address

3030 North St
Suite 312
Beaumont, TX 77702-1433

Phone

(409) 899-2020

Fax

(409) 899-2121

NPI assigned

Jul 10, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Dominique J Beaudry, MDNPI 1437339223

Title

MD/Owner

Phone

(409) 899-2121

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Dominique J. Beaudry, MD

  • Interventional Cardiology Physician
  • Shreveport, LA
  • NPI 1437339223

  Cardiovascular Disease

  NPD (past) Authorized official

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316736000000",
    "number": "1467616201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 NORTH ST",
            "address_2": "SUITE 312",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021433",
            "telephone_number": "409-899-2020",
            "fax_number": "409-899-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 NORTH ST",
            "address_2": "SUITE 312",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021433",
            "telephone_number": "409-899-2020",
            "fax_number": "409-899-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMINIQUE J BEAUDRY MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-10",
        "last_updated": "2011-09-23",
        "status": "A",
        "authorized_official_last_name": "BEAUDRY",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "409-899-2121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "M9151",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "M9151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197371102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Michelle Doguet, MD
• Mariah Dolbow, COTA/L
• Jackson Dolce, OD
• Charles Chester Domingues, M.D.
• Kayla Dominguez, PA
• Stacy Dominy, APRN, FNP-C
• Denise Lynn Donahue, LPC-A
• Andrea R. Donart, LCSW
• Jennifer L Dorrell, M.S. LPC
• Katherine Ann Dos Santos, OTR

• Interventional Cardiology Physician in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Interventional Cardiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.

Verify at the official NPI Registry.