Provider Demographics
NPI:1538287586
Name:BEAUJEAN, A. ALEXANDER (PHD)
Entity Type:Individual
Prefix:DR
First Name:A.
Middle Name:ALEXANDER
Last Name:BEAUJEAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 SAPPHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:HEWITT
Mailing Address - State:TX
Mailing Address - Zip Code:76643-2999
Mailing Address - Country:US
Mailing Address - Phone:254-666-2890
Mailing Address - Fax:
Practice Address - Street 1:700 SAPPHIRE BLVD
Practice Address - Street 2:
Practice Address - City:HEWITT
Practice Address - State:TX
Practice Address - Zip Code:76643-2999
Practice Address - Country:US
Practice Address - Phone:254-666-2890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2010-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33540103TC2200X, 103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool