Provider Demographics
NPI:1932148186
Name:BEAN, LAWRENCE ALBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:ALBERT
Last Name:BEAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 OLD FM 548
Mailing Address - Street 2:SUITE 124
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:426 OLD FM 548
Practice Address - Street 2:SUITE 124
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126
Practice Address - Country:US
Practice Address - Phone:972-564-0044
Practice Address - Fax:972-564-0054
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1503207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0008PVOtherBLUE CROSS BLUE SHIELD
8AE542OtherBCBS OF TEXAS
TX0097NAOtherBCBS
TX177760901Medicaid
TXP00316914Medicare PIN
8AE542OtherBCBS OF TEXAS
TX0097NAOtherBCBS