1295082535 NPI number — MRS. LYNDA RHEA BEAN RDH

Table of content: MRS. LYNDA RHEA BEAN RDH (NPI 1295082535)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295082535 NPI number — MRS. LYNDA RHEA BEAN RDH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BEAN
Provider First Name:
LYNDA
Provider Middle Name:
RHEA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RDH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295082535
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/12/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1476 LONG MDW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALADO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76571-5367
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
254-681-4623
Provider Business Mailing Address Fax Number:
254-939-2700

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1476 LONG MDW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALADO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76571-5367
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-681-4623
Provider Business Practice Location Address Fax Number:
254-939-2700
Provider Enumeration Date:
08/06/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 124Q00000X , with the licence number:  7178 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7178 . This is a "TEXAS STATE BOARD OF DENTAL EXAMINERS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com