Provider Demographics
NPI:1275651648
Name:BECKER,, STEPHEN H (DDS, PLLC)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:H
Last Name:BECKER,
Suffix:
Gender:M
Credentials:DDS, PLLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CHISHOLM TRL
Mailing Address - Street 2:SUITE 3130
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-5042
Mailing Address - Country:US
Mailing Address - Phone:512-255-9061
Mailing Address - Fax:512-255-1422
Practice Address - Street 1:1 CHISHOLM TRL
Practice Address - Street 2:SUITE 3130
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-5008
Practice Address - Country:US
Practice Address - Phone:512-255-9061
Practice Address - Fax:512-255-1422
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12409122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX12409OtherLICENSE NUMBER