Healthcare Provider Details

I. General information

NPI: 1134993991
Provider Name (Legal Business Name): MADELINE JOY BEBEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2023
Last Update Date: 02/19/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1495 N 7TH ST
BEAUMONT TX
77702-1345
US

IV. Provider business mailing address

1495 N 7TH ST
BEAUMONT TX
77702-1345
US

V. Phone/Fax

Practice location:
  • Phone: 409-832-3377
  • Fax:
Mailing address:
  • Phone: 409-832-3377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1067138
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: