Provider Demographics
NPI:1548540685
Name:BEAUMONT, TRACEE (L AC)
Entity type:Individual
Prefix:
First Name:TRACEE
Middle Name:
Last Name:BEAUMONT
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 W. SEALY ST.
Mailing Address - Street 2:SUITE 7
Mailing Address - City:ALVIN
Mailing Address - State:TX
Mailing Address - Zip Code:77511
Mailing Address - Country:US
Mailing Address - Phone:346-208-8764
Mailing Address - Fax:
Practice Address - Street 1:211 W. SEALY ST.
Practice Address - Street 2:SUITE 7
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511
Practice Address - Country:US
Practice Address - Phone:346-208-8764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-21
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01286171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist