Provider Demographics
NPI:1083702179
Name:MCCANN, JAMES BEEBE (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:BEEBE
Last Name:MCCANN
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 1:2704 TRUMAN CV
Mailing Address - Street 2:
Mailing Address - City:LAGO VISTA
Mailing Address - State:TX
Mailing Address - Zip Code:78645-7347
Mailing Address - Country:US
Mailing Address - Phone:512-267-6992
Mailing Address - Fax:512-324-7366
Practice Address - Street 1:501 E. 15TH STREET
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-7404
Practice Address - Country:US
Practice Address - Phone:512-324-7393
Practice Address - Fax:512-324-7366
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15314183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist