Provider Demographics
NPI:1316550247
Name:BECK, RODNEY DEAN (MA)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:DEAN
Last Name:BECK
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9814 RIDGEHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-2621
Mailing Address - Country:US
Mailing Address - Phone:469-774-3595
Mailing Address - Fax:
Practice Address - Street 1:9814 RIDGEHAVEN DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-2621
Practice Address - Country:US
Practice Address - Phone:469-774-3595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-29
Last Update Date:2020-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14828101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty