MEDICARE: DR. LISA BEAM PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	44683	TX
2	183500000X	Pharmacist	018031	LA

General Provider Information

NPI Number	:	1295155539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA BEAM PHARMD

Provider Business Mailing Address
First Line	:	2343 KYLIE CT
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-3321
Country	:	US
Telephone Number	:	832-578-1082
Fax Number	:	281-356-9659

Provider Business Practice Location Address
First Line	:	2343 KYLIE CT
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-3321
Country	:	US
Telephone Number	:	832-578-1082
Fax Number	:	281-356-9659

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2014
Last Update Date	:	04/25/2014

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