Provider Demographics
NPI:1548365174
Name:BEVERS, TERRY BARTHOLOMEW (MD)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:BARTHOLOMEW
Last Name:BEVERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:THERESE
Other - Middle Name:B
Other - Last Name:BEVERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 4439
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4439
Mailing Address - Country:US
Mailing Address - Phone:713-792-2991
Mailing Address - Fax:
Practice Address - Street 1:1515 HOLCOMBE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4000
Practice Address - Country:US
Practice Address - Phone:713-792-6161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4153207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080088642OtherRR MEDICARE
TX82M405OtherBCBS
TX125173801Medicaid
TX82M405OtherBCBS
E04579Medicare UPIN