Provider Demographics
NPI:1861681736
Name:C. RENEE BEAN D.O., P.A.
Entity Type:Organization
Organization Name:C. RENEE BEAN D.O., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:C.
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BEAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:903-876-5888
Mailing Address - Street 1:306 E MURCHISON ST
Mailing Address - Street 2:
Mailing Address - City:FRANKSTON
Mailing Address - State:TX
Mailing Address - Zip Code:75763-2654
Mailing Address - Country:US
Mailing Address - Phone:903-876-5888
Mailing Address - Fax:903-876-5889
Practice Address - Street 1:306 E MURCHISON ST
Practice Address - Street 2:
Practice Address - City:FRANKSTON
Practice Address - State:TX
Practice Address - Zip Code:75763-2654
Practice Address - Country:US
Practice Address - Phone:903-876-5888
Practice Address - Fax:903-876-5889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1526207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00563TMedicare PIN