Provider Demographics
NPI:1124465034
Name:MACDONALD WER, BEATRIZ MICHELLE (PHD)
Entity type:Individual
Prefix:DR
First Name:BEATRIZ
Middle Name:MICHELLE
Last Name:MACDONALD WER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:BEATRIZ
Other - Middle Name:MICHELLE
Other - Last Name:MACDONALD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 2603
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76113-2603
Mailing Address - Country:US
Mailing Address - Phone:817-335-3022
Mailing Address - Fax:
Practice Address - Street 1:3840 HULEN ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-7277
Practice Address - Country:US
Practice Address - Phone:817-335-3022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38333208000000X
TX38388103T00000X, 208000000X, 2080P0006X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics