Provider Demographics
NPI:1497976864
Name:BECKER, TAJ N (MD)
Entity Type:Individual
Prefix:
First Name:TAJ
Middle Name:N
Last Name:BECKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TAJBIBI
Other - Middle Name:NOORUDIN
Other - Last Name:BILLAWALA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:736 S 900 E
Mailing Address - Street 2:202
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-7000
Mailing Address - Country:US
Mailing Address - Phone:435-688-7800
Mailing Address - Fax:435-688-7801
Practice Address - Street 1:736 S 900 E
Practice Address - Street 2:202
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-7000
Practice Address - Country:US
Practice Address - Phone:435-688-7800
Practice Address - Fax:435-688-7801
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT269427-12052084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology