Robert Coleson Beavis, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

M7033 Issued in TX

Practice address

4031 W Plano Pkwy Ste 100
Plano, TX 75093-5617

Phone

(972) 985-1072

Fax

(972) 964-3469

NPI assigned

Sep 5, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1962696765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4031 W PLANO PKWY STE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935617",
            "telephone_number": "972-985-1072",
            "fax_number": "972-964-3469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4031 W PLANO PKWY STE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935617",
            "telephone_number": "972-985-1072",
            "fax_number": "972-964-3469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAVIS",
        "first_name": "ROBERT",
        "middle_name": "COLESON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-05",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "M7033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPS",
            "identifier": "C0154352",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Orthopaedic Surgery Physician in Plano, TX
• Providers in Plano, TX by specialty
• Orthopaedic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; 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.