Provider Demographics
NPI:1679754030
Name:BEARD, ELIZABETH A (DDS)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:A
Last Name:BEARD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3819 22ND PL
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1117
Mailing Address - Country:US
Mailing Address - Phone:806-793-5454
Mailing Address - Fax:
Practice Address - Street 1:3819 22ND PL
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1117
Practice Address - Country:US
Practice Address - Phone:806-793-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-14
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23834122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist