Provider Demographics
NPI:1114121597
Name:STEPHEN BECKER
Entity Type:Organization
Organization Name:STEPHEN BECKER
Other - Org Name:STEPHEN BECKER MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-821-0588
Mailing Address - Street 1:9729 WINDY HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-5011
Mailing Address - Country:US
Mailing Address - Phone:214-821-0588
Mailing Address - Fax:972-831-9338
Practice Address - Street 1:3801 GASTON AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1541
Practice Address - Country:US
Practice Address - Phone:214-821-0588
Practice Address - Fax:972-831-9338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3679174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty