Provider Demographics
NPI:1649063165
Name:BEARD, SPARKLE (CNA)
Entity type:Individual
Prefix:
First Name:SPARKLE
Middle Name:
Last Name:BEARD
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 JONES DR APT 2431
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77551-2145
Mailing Address - Country:US
Mailing Address - Phone:281-987-4105
Mailing Address - Fax:
Practice Address - Street 1:238 S EGRET BAY BLVD # 1064
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-2682
Practice Address - Country:US
Practice Address - Phone:281-987-4105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA0061030276374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide