Provider Demographics
NPI:1740502400
Name:JENKINS BEY, ERIC
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:JENKINS BEY
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:SIMEL
Other - Middle Name:
Other - Last Name:BEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DIPLOM
Mailing Address - Street 1:317 RR 620 SOUTH, #102
Mailing Address - Street 2:
Mailing Address - City:LAKEWAY
Mailing Address - State:TX
Mailing Address - Zip Code:78734
Mailing Address - Country:US
Mailing Address - Phone:512-536-0801
Mailing Address - Fax:
Practice Address - Street 1:317 RR 620 S STE 102
Practice Address - Street 2:
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78734-4727
Practice Address - Country:US
Practice Address - Phone:512-536-0801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00873171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist