Provider Demographics
NPI:1750261970
Name:BEARD, DOREEN DEMITRA
Entity type:Individual
Prefix:
First Name:DOREEN
Middle Name:DEMITRA
Last Name:BEARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 HAVENROCK DR
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-6261
Mailing Address - Country:US
Mailing Address - Phone:214-469-9483
Mailing Address - Fax:
Practice Address - Street 1:1530 HAVENROCK DR
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-6261
Practice Address - Country:US
Practice Address - Phone:214-469-9483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant