Provider Demographics
NPI:1831792712
Name:BEEBE, MADISON DIANE
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:DIANE
Last Name:BEEBE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16606 SEMINARY RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-5848
Mailing Address - Country:US
Mailing Address - Phone:805-478-6486
Mailing Address - Fax:
Practice Address - Street 1:16606 SEMINARY RIDGE LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-5848
Practice Address - Country:US
Practice Address - Phone:805-478-6486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician