Healthcare Provider Details

I. General information

NPI: 1558074104
Provider Name (Legal Business Name): HAILEY LYNN BEELER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2022
Last Update Date: 12/28/2022
Certification Date: 12/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 SAWDUST RD # F
SPRING TX
77380-2366
US

IV. Provider business mailing address

307 SAWDUST RD # F
SPRING TX
77380-2366
US

V. Phone/Fax

Practice location:
  • Phone: 346-351-2923
  • Fax: 346-229-1676
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: