Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 14840 | TX |
N | 1223D0001X | Dental Public Health | 14840 | TX |
Y | 1223G0001X | General Practice | 14840 | TX |
Y | 213EG0000X | General Practice | 14840 | TX |
NPI | 1649262197 |
---|---|
Provider Name | Dr. Rhonda Lonell Bean |
First Address | Houston, TX 77054-2032 |
Second Address | Houston, TX 77095-4388 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2005 |
Last Update Date | 12/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1109415-02 | (05) | TX |