Provider Demographics
NPI:1619492089
Name:BEYER, JACQUELINE T (FNP)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:T
Last Name:BEYER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5930 HIGHWAY 6 N STE A2
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-1855
Mailing Address - Country:US
Mailing Address - Phone:281-856-7878
Mailing Address - Fax:
Practice Address - Street 1:2626 SPENCER HWY
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-1021
Practice Address - Country:US
Practice Address - Phone:281-974-2102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-07
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134362363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily