Provider Demographics
NPI:1114244258
Name:BEVERLY J LALLANDE MD PA
Entity Type:Organization
Organization Name:BEVERLY J LALLANDE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:LALLANDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-252-7256
Mailing Address - Street 1:6945 BURGESS ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77021-2011
Mailing Address - Country:US
Mailing Address - Phone:713-252-7256
Mailing Address - Fax:
Practice Address - Street 1:6945 BURGESS ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021-2011
Practice Address - Country:US
Practice Address - Phone:713-252-7256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-29
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM81102084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty