Provider Demographics
NPI:1336029123
Name:BEARD, CHRISTIAN LUND
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:LUND
Last Name:BEARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11808 PLEASANT PANORAMA VW
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78738-5307
Mailing Address - Country:US
Mailing Address - Phone:512-917-2319
Mailing Address - Fax:
Practice Address - Street 1:11808 PLEASANT PANORAMA VW
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78738-5307
Practice Address - Country:US
Practice Address - Phone:512-917-2319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41956122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist