Provider Demographics
NPI:1013221852
Name:BEITEL, JAMES STEWART (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:STEWART
Last Name:BEITEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 W BANDERA RD # 327
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-2805
Mailing Address - Country:US
Mailing Address - Phone:210-857-0847
Mailing Address - Fax:
Practice Address - Street 1:1223 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-2813
Practice Address - Country:US
Practice Address - Phone:830-249-9585
Practice Address - Fax:830-249-9485
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21743183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist