Provider Demographics
NPI:1295155539
Name:BEAM, LISA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:BEAM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2343 KYLIE CT
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-3321
Mailing Address - Country:US
Mailing Address - Phone:832-578-1082
Mailing Address - Fax:281-356-9659
Practice Address - Street 1:2343 KYLIE CT
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-3321
Practice Address - Country:US
Practice Address - Phone:832-578-1082
Practice Address - Fax:281-356-9659
Is Sole Proprietor?:No
Enumeration Date:2014-04-25
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44683183500000X
LA018031183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist