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NPI Code Detail

MEDICARE: MRS. JAMIE MARIE BEARDEN

MEDICARE: MRS. JAMIE MARIE BEARDEN
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
1183500000XPharmacist36512TX

General Provider Information

NPI Number : 1134455876
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JAMIE MARIE BEARDEN
Provider Business Mailing Address
First Line : 1100 FLOWER MOUND RD
Second Line :
City : FLOWER MOUND
State : TX
Zip : 75028-3503
Country : US
Telephone Number : 972-874-8421
Fax Number :
Provider Business Practice Location Address
First Line : 1100 FLOWER MOUND RD
Second Line :
City : FLOWER MOUND
State : TX
Zip : 75028-3503
Country : US
Telephone Number : 972-874-8421
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2009
Last Update Date : 11/24/2020

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Directions to “ MRS. JAMIE MARIE BEARDEN ” Practice Location

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