Provider Demographics
NPI:1467108977
Name:MCSHANE, MAUREEN BEITER (RPH)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:BEITER
Last Name:MCSHANE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 MUELLER BLVD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-3051
Mailing Address - Country:US
Mailing Address - Phone:512-324-0149
Mailing Address - Fax:512-324-0756
Practice Address - Street 1:4900 MUELLER BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3051
Practice Address - Country:US
Practice Address - Phone:512-324-0149
Practice Address - Fax:512-324-0756
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29489183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist