Carl J Beaudry, MD, PA

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

E9531 Issued in TX

Legal business name

CARL J BEAUDRY, MD, PA

Practice address

2501 Jimmy Johnson Blvd Ste 202
Port Arthur, TX 77640-2009

Phone

(409) 722-4446

Fax

(409) 722-4448

NPI assigned

Aug 14, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Shanna Laree Trejo

Title

Practice Manager

Phone

(409) 722-4446

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187049600000",
    "number": "1992997910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 JIMMY JOHNSON BLVD STE 202",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776402009",
            "telephone_number": "409-722-4446",
            "fax_number": "409-722-4448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 JIMMY JOHNSON BLVD STE 202",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776402009",
            "telephone_number": "409-722-4446",
            "fax_number": "409-722-4448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARL J BEAUDRY, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-14",
        "last_updated": "2007-08-14",
        "status": "A",
        "authorized_official_last_name": "TREJO",
        "authorized_official_first_name": "SHANNA",
        "authorized_official_middle_name": "LAREE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "409-722-4446",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "E9531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "8B7430",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Roman Jules Carpenter, NP
• Elizabeth Mary Carter, MSN,RN,CPNP

• Orthopaedic Surgery Physician in Port Arthur, TX
• Providers in Port Arthur, 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 Aug 14, 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.