Provider Demographics
NPI:1265432249
Name:BEAN, E.
Entity type:Individual
Prefix:DR
First Name:E.
Middle Name:
Last Name:BEAN
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:E.
Other - Middle Name:
Other - Last Name:BEAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:PO BOX 1364
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76053-1364
Mailing Address - Country:US
Mailing Address - Phone:817-282-8746
Mailing Address - Fax:
Practice Address - Street 1:233 RIDGECREST DR
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76053-6554
Practice Address - Country:US
Practice Address - Phone:817-282-8746
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2377152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist