Provider Demographics
NPI:1053491241
Name:NAUM I BECKER MD PA
Entity Type:Organization
Organization Name:NAUM I BECKER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:NAUM
Authorized Official - Middle Name:I
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:817-548-7711
Mailing Address - Street 1:6201 MATLOCK ROAD
Mailing Address - Street 2:STE 139
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-2763
Mailing Address - Country:US
Mailing Address - Phone:817-548-7711
Mailing Address - Fax:817-557-1452
Practice Address - Street 1:6201 MATLOCK ROAD
Practice Address - Street 2:STE 139
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76002-2763
Practice Address - Country:US
Practice Address - Phone:817-548-7711
Practice Address - Fax:817-557-1452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG2641208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX126971401Medicaid
TX1053491241OtherBC/BS
TX1053491241OtherBC/BS