Provider Demographics
NPI:1518295492
Name:BESHEAR, MYRA (PHARM D)
Entity Type:Individual
Prefix:
First Name:MYRA
Middle Name:
Last Name:BESHEAR
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11724 RESEARCH BLVD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-2446
Mailing Address - Country:US
Mailing Address - Phone:512-250-2070
Mailing Address - Fax:512-250-5359
Practice Address - Street 1:11724 RESEARCH BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-2446
Practice Address - Country:US
Practice Address - Phone:512-250-2070
Practice Address - Fax:512-250-5359
Is Sole Proprietor?:No
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43099183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist