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NPI Code Detail

MEDICARE: DR. BRANDY LA'SHAY BEAUCHAMP MD

MEDICARE: DR. BRANDY LA'SHAY BEAUCHAMP MD
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
12084P0800XPsychiatry PhysicianN4288TX
2208000000XPediatrics PhysicianN4288TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245434844
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRANDY LA'SHAY BEAUCHAMP MD
Provider Business Mailing Address
First Line : 1601 RIO GRANDE ST
Second Line : SUITE 340
City : AUSTIN
State : TX
Zip : 78701-1137
Country : US
Telephone Number : 512-324-8960
Fax Number : 512-324-8962
Provider Business Practice Location Address
First Line : 7877 WILLOW CHASE BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77070-5934
Country : US
Telephone Number : 832-869-4818
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2007
Last Update Date : 09/12/2023

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