Provider Demographics
NPI:1851371512
Name:BEACH, ROBYN A (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBYN
Middle Name:A
Last Name:BEACH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:P.O. BOX 421849
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77242-1849
Mailing Address - Country:US
Mailing Address - Phone:713-559-6929
Mailing Address - Fax:713-559-6928
Practice Address - Street 1:2525 WEST BELLFORT STREET
Practice Address - Street 2:STE 120
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-5024
Practice Address - Country:US
Practice Address - Phone:713-741-6677
Practice Address - Fax:713-748-5860
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8279207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165668803Medicaid