MEDICARE: DR. JANE LOUISE BEAUVAIS M.D.

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	207R00000X	Internal Medicine Physician	J7304	TX

General Provider Information

NPI Number	:	1871517417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANE LOUISE BEAUVAIS M.D.

Provider Business Mailing Address
First Line	:	201 KINGWOOD MEDICAL DR
Second Line	:	SUITE A-300
City	:	KINGWOOD
State	:	TX
Zip	:	77339-6006
Country	:	US
Telephone Number	:	281-973-1564
Fax Number	:	281-973-1569

Provider Business Practice Location Address
First Line	:	201 KINGWOOD MEDICAL DR
Second Line	:	SUITE A-300
City	:	KINGWOOD
State	:	TX
Zip	:	77339-6006
Country	:	US
Telephone Number	:	281-973-1564
Fax Number	:	281-973-1569

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	07/07/2009

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