Provider Demographics
NPI:1871517417
Name:BEAUVAIS, JANE LOUISE (MD)
Entity type:Individual
Prefix:DR
First Name:JANE
Middle Name:LOUISE
Last Name:BEAUVAIS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:201 KINGWOOD MEDICAL DR
Mailing Address - Street 2:SUITE A-300
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-6006
Mailing Address - Country:US
Mailing Address - Phone:281-973-1564
Mailing Address - Fax:281-973-1569
Practice Address - Street 1:201 KINGWOOD MEDICAL DR
Practice Address - Street 2:SUITE A-300
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-6006
Practice Address - Country:US
Practice Address - Phone:281-973-1564
Practice Address - Fax:281-973-1569
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ7304207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F21118Medicare PIN
TXG31593Medicare UPIN