Provider Demographics
NPI:1558708305
Name:BEATHARD, KAREN MYNHIER (RD, LD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:MYNHIER
Last Name:BEATHARD
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2734 CLOISTERS DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-4826
Mailing Address - Country:US
Mailing Address - Phone:979-220-2281
Mailing Address - Fax:
Practice Address - Street 1:207 ROCK PRAIRIE RD
Practice Address - Street 2:SUITE B
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-8777
Practice Address - Country:US
Practice Address - Phone:979-220-2281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-03
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT05309133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered