MEDICARE: ROBERT WAYNE BEAUDOIN

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	183500000X	Pharmacist	76698	TX

General Provider Information

NPI Number	:	1982370466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT WAYNE BEAUDOIN

Provider Business Mailing Address
First Line	:	693 WHITE BEAR TRL
Second Line	:
City	:	LINDALE
State	:	TX
Zip	:	75771-6659
Country	:	US
Telephone Number	:	903-423-0904
Fax Number	:

Provider Business Practice Location Address
First Line	:	3092 N EASTMAN RD STE 100
Second Line	:
City	:	LONGVIEW
State	:	TX
Zip	:	75605-7950
Country	:	US
Telephone Number	:	903-323-5001
Fax Number	:

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

Provider Enumeration Date	:	08/17/2021
Last Update Date	:	12/15/2025

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Directions to “ ROBERT WAYNE BEAUDOIN ” Practice Location

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