Individual
BROOKE BALLASES BEEBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
12200 RENFERT WAY, STE 100, AUSTIN, TX 78758-5614
(512) 451-8211
Mailing address
12200 RENFERT WAY STE 100, AUSTIN, TX 78758-5614
(512) 451-8211
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA06726
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
70174346
DPS
TX
01
—
PA06726
PA LICENSE NUMBER
TX
Enumeration date
02/03/2011
Last updated
02/03/2011
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