MS. DORACE LISA BEDARD


Address: 5509 Attwater Ave, Dickinson, TX 77539-4157
Phone: 4099480001

MS. DORACE LISA BEDARD (NPI# 1992102149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1992102149
Entity Type Individual
Full Name MS. DORACE LISA BEDARD
Credential N.P.
Practice Address 5509 Attwater Ave
Dickinson
TX 77539-4157
Mailing Address 3227 Moss St
La Marque
TX 77568-4612
Practice Telephone 4099480001
Mailing Telephone 4099353423
Enumeration Date 2014-12-02
Last Update Date 2014-12-02
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
AP114077 TX Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 5509 ATTWATER AVE
City DICKINSON
State TX
Zip Code 77539-4157

Providers in the same location

NPI Name Taxonomy Address Enumeration
1942545488 Robert Knoth Physician Assistant 5509 Attwater Ave, Dickinson, TX 77539-4157 2012-12-11
1578068193 Brandon Lemar Johnson Family Medicine 5509 Attwater Ave, Dickinson, TX 77539-4157 2018-03-26
1326447376 Joe Robert Taylor Internal Medicine 5509 Attwater Ave, Carole Young Medical Facility, Dickinson, TX 77539-4157 2014-08-15

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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

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Competitor

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City DICKINSON
Zip Code 77539

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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