Provider Demographics
NPI:1114441177
Name:BECKER, PALOMA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:PALOMA
Middle Name:
Last Name:BECKER
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7420 REMCON CIR STE A
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-3537
Mailing Address - Country:US
Mailing Address - Phone:915-523-8823
Mailing Address - Fax:
Practice Address - Street 1:7420 REMCON CIR STE A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-3537
Practice Address - Country:US
Practice Address - Phone:915-532-8823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-01
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134712363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP134712OtherNURSE PRACTITIONER LICENSE NUMBER