Provider Demographics
NPI:1023571833
Name:BEAN, DOLORES MARIE
Entity Type:Individual
Prefix:
First Name:DOLORES
Middle Name:MARIE
Last Name:BEAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 FROSTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-4131
Mailing Address - Country:US
Mailing Address - Phone:713-468-2330
Mailing Address - Fax:832-358-9301
Practice Address - Street 1:833 FROSTWOOD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-4131
Practice Address - Country:US
Practice Address - Phone:713-468-2330
Practice Address - Fax:832-358-9301
Is Sole Proprietor?:No
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80764237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist