Provider Demographics
NPI:1295082535
Name:BEAN, LYNDA RHEA (RDH)
Entity type:Individual
Prefix:MRS
First Name:LYNDA
Middle Name:RHEA
Last Name:BEAN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1476 LONG MDW
Mailing Address - Street 2:
Mailing Address - City:SALADO
Mailing Address - State:TX
Mailing Address - Zip Code:76571-5367
Mailing Address - Country:US
Mailing Address - Phone:254-681-4623
Mailing Address - Fax:254-939-2700
Practice Address - Street 1:1476 LONG MDW
Practice Address - Street 2:
Practice Address - City:SALADO
Practice Address - State:TX
Practice Address - Zip Code:76571-5367
Practice Address - Country:US
Practice Address - Phone:254-681-4623
Practice Address - Fax:254-939-2700
Is Sole Proprietor?:No
Enumeration Date:2012-08-06
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7178124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7178OtherTEXAS STATE BOARD OF DENTAL EXAMINERS