Provider Demographics
NPI:1669774436
Name:BEAN, DEE A (PA-C)
Entity type:Individual
Prefix:
First Name:DEE
Middle Name:A
Last Name:BEAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DEE
Other - Middle Name:ANN
Other - Last Name:BEAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:813 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MONAHANS
Mailing Address - State:TX
Mailing Address - Zip Code:79756-4015
Mailing Address - Country:US
Mailing Address - Phone:432-943-2068
Mailing Address - Fax:432-943-3114
Practice Address - Street 1:406 S GARY AVE
Practice Address - Street 2:
Practice Address - City:MONAHANS
Practice Address - State:TX
Practice Address - Zip Code:79756-4799
Practice Address - Country:US
Practice Address - Phone:432-943-2511
Practice Address - Fax:432-943-3114
Is Sole Proprietor?:No
Enumeration Date:2010-11-29
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06958363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant