Provider Demographics
NPI:1699453563
Name:BEUSTRING, PENNY GAIL
Entity type:Individual
Prefix:
First Name:PENNY
Middle Name:GAIL
Last Name:BEUSTRING
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 1:5110 WATERBECK ST
Mailing Address - Street 2:
Mailing Address - City:WESTON LAKES
Mailing Address - State:TX
Mailing Address - Zip Code:77441-4100
Mailing Address - Country:US
Mailing Address - Phone:509-863-1633
Mailing Address - Fax:
Practice Address - Street 1:6901 BERTNER AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3901
Practice Address - Country:US
Practice Address - Phone:713-500-4472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1014654163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse