Provider Demographics
NPI:1730464819
Name:BEAUCHAMP, VIRGINIA LOW (MT-BC)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:LOW
Last Name:BEAUCHAMP
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14500 CUTTEN RD APT 14307
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-1006
Mailing Address - Country:US
Mailing Address - Phone:281-827-5498
Mailing Address - Fax:
Practice Address - Street 1:14500 CUTTEN RD APT 14307
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-1006
Practice Address - Country:US
Practice Address - Phone:281-827-5498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX08358225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist