Provider Demographics
NPI:1245528256
Name:MAYFIELD, BEVERLY JOYCE
Entity type:Individual
Prefix:MISS
First Name:BEVERLY
Middle Name:JOYCE
Last Name:MAYFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1224 S ROGERS RD # 1224
Mailing Address - Street 2:1224 S. ROGERS RD. #1224
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75060-3765
Mailing Address - Country:US
Mailing Address - Phone:469-735-0364
Mailing Address - Fax:
Practice Address - Street 1:1224 S ROGERS RD # 1224
Practice Address - Street 2:1224 S. ROGERS RD. #1224
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75060-3765
Practice Address - Country:US
Practice Address - Phone:469-735-0364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child