Provider Demographics
NPI:1477925279
Name:BEILMAN, DIANA LANE (LAC)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:LANE
Last Name:BEILMAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 WALLINGWOOD DR BLDG 7C STE #705
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6929
Mailing Address - Country:US
Mailing Address - Phone:360-556-0975
Mailing Address - Fax:512-692-1826
Practice Address - Street 1:2525 WALLINGWOOD DR
Practice Address - Street 2:BLDG 7C STE #705
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-6929
Practice Address - Country:US
Practice Address - Phone:360-556-0975
Practice Address - Fax:512-692-1826
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-20
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01647171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist