Basic Information
| Provider Information | |||||||||
| NPI: | 1942639455 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DR. SAMUEL F BEAN, MD, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 BINZ ST STE 1110 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770046935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7135238200 | ||||||||
| FaxNumber: | 7135238678 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 BINZ ST STE 1110 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770046935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7135238200 | ||||||||
| FaxNumber: | 7135238678 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/05/2013 | ||||||||
| LastUpdateDate: | 11/05/2013 | ||||||||
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| AuthorizedOfficialLastName: | BEAN | ||||||||
| AuthorizedOfficialFirstName: | SAMUEL | ||||||||
| AuthorizedOfficialMiddleName: | FRANKLIN | ||||||||
| AuthorizedOfficialTitleorPosition: | DOCTOR | ||||||||
| AuthorizedOfficialTelephone: | 7135238200 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | DR. SAMUEL F BEAN | ||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ND0900X | D0045 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Dermatology | Dermatopathology |
No ID Information.