Provider Demographics
NPI:1326330648
Name:BECK, E RYAN
Entity Type:Individual
Prefix:MR
First Name:E
Middle Name:RYAN
Last Name:BECK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23872 E 1035 RD
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:OK
Mailing Address - Zip Code:73096-7521
Mailing Address - Country:US
Mailing Address - Phone:405-929-9865
Mailing Address - Fax:
Practice Address - Street 1:23872 E 1035 RD
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:OK
Practice Address - Zip Code:73096-7521
Practice Address - Country:US
Practice Address - Phone:405-929-9865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health