NPI age
17 years
Enumerated 2008-10-14
● Active
Type 1 · Individual
Lara Jennifer Beverly, P.A.
Beverly is 1 of 10 physician assistant providers in Sulphur Springs and 1 of 11022 in Texas.
Primary specialty
Physician Assistant
Licensed in
TX
1 state
Status
Active
No deactivations on record
Last NPPES update
2021-03-23
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 11022 active physician assistant providers in Texas.
NPI age
17 years
↑ 7 yr above median (10 yr)
State licenses
1 state
7% of peers hold multiple states
Subspecialties
0
23% of peers hold subspecialties
NPI lifetime · 2008 → 2026
2008-10Enumerated in NPPES
2008
2026
Where they practice
Practice location
1339 S Broadway St
Sulphur Springs, TX 754824895
Mailing address
1136 E Grande Blvd
Tyler, TX 757033982
Additional practice locations
1 secondary location on file with NPPES.
Location 2
1136 E Grande Blvd
Tyler, TX 757033982
Specialties
-
Physician Assistant PrimaryA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 210066104 | |
| 05 (TX) | 210066106 | |
| 01 (TX) | 8Y9005 | BCBS |
Practice context
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.