Provider Demographics
NPI:1023493228
Name:BEYOND MEDICINE
Entity type:Organization
Organization Name:BEYOND MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LANE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEBRING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-847-5618
Mailing Address - Street 1:16811 RANCH ROAD 12
Mailing Address - Street 2:
Mailing Address - City:WIMBERLEY
Mailing Address - State:TX
Mailing Address - Zip Code:78676-6070
Mailing Address - Country:US
Mailing Address - Phone:512-847-5618
Mailing Address - Fax:512-847-8746
Practice Address - Street 1:16811 RANCH ROAD 12
Practice Address - Street 2:
Practice Address - City:WIMBERLEY
Practice Address - State:TX
Practice Address - Zip Code:78676-6070
Practice Address - Country:US
Practice Address - Phone:512-847-5618
Practice Address - Fax:512-847-8746
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SEBRING CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7661261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center