Active NPI
Patrick Daniel Beetar, D.D.S.
- Oral and Maxillofacial Surgery (Dentist)
- Houston, TX
National Provider Identifier
1568777969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 25731
- Practice address
- 107 Yale St
Suite 300
Houston, TX 77007-3753 - Phone
- (823) 462-7633
- NPI assigned
- Aug 10, 2010
- 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 |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 25731 | TX | Primary |
Addresses
Primary practice location
107 Yale St
Suite 300
Houston, TX 77007-3753
Mailing address
107 Yale St
Suite 300
Houston, TX 77007-3753
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160614001801 | TX | Order and Referring Only - Oral Surgery | 2062702822 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25731 | TX | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469923200000",
"number": "1568777969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 YALE ST",
"address_2": "SUITE 300",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770073753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 YALE ST",
"address_2": "SUITE 300",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770073753",
"telephone_number": "823-462-7633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEETAR",
"first_name": "PATRICK",
"middle_name": "DANIEL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-08-10",
"last_updated": "2016-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "TX",
"license": "25731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.