D'Andra Michelle Beaulieu, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

106092 Issued in TX

Practice address

730 S Chilton Ave
Tyler, TX 75701-1576

Phone

(903) 262-3200

Fax

(903) 262-3218

NPI assigned

May 14, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477769008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14205 COUNTY ROAD 343",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757082159",
            "telephone_number": "903-877-3243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 S CHILTON AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011576",
            "telephone_number": "903-262-3200",
            "fax_number": "903-262-3218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAULIEU",
        "first_name": "D'ANDRA",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "106092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Virginia B Beall, M.D.
• Ronald David Beals, M.D.
• Alexandria Beard
• Jasmine Beasley
• Taylor Beasley, RN
• Marla Becerra
• David Beck, P.A.
• Lindsay Beck
• Stephen John Beck, MD
• Timothy Lamar Beck, MD

• Occupational Therapist in Tyler, TX
• Providers in Tyler, TX by specialty
• Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.