Provider Demographics
NPI:1013210905
Name:JANET K BECKER, MD PA
Entity Type:Organization
Organization Name:JANET K BECKER, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:K
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-671-7546
Mailing Address - Street 1:900 ROUND ROCK AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-4510
Mailing Address - Country:US
Mailing Address - Phone:512-671-7546
Mailing Address - Fax:
Practice Address - Street 1:900 ROUND ROCK AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4510
Practice Address - Country:US
Practice Address - Phone:512-671-7546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-14
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6041207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF39087Medicare UPIN