GLEN A BEEDE DPM PA
Ambulatory Health at Bellaire Dr, Fort Worth, TX

License number
Texas 1317
Category
Ambulatory Health
Type
Podiatric
Owner
Name: GLEN ALAN BEEDE DPM
Title: OWNER
Phone: (817) 763-9383
Address
Address
5521 Bellaire Dr S STE 116, Fort Worth, TX 76109
National Provider ID: 1407033400
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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GLEN A. BEEDE, D.P.M., PA

5521 Bellaire Dr S STE 116, Fort Worth, TX 76109

Doing business as:
Glen A. Beede, D.P.M., PA
Registration:
Oct 8, 1996
State ID:
0081757303
Business type:
Professional Association
President , Treasurer , Secretary , Director , Member , Vice-President:
Glen A. Beede (President , Treasurer , Secretary , Director , Member , Vice-President)
Agent:
Glen A Beede,5521 Bellaire Dr So SUITE 116, Fort Worth, TX 76109 (Physical)
TIN:
32036012048

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