Provider Demographics
NPI:1518910546
Name:BECEIRO, JOSE R (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:R
Last Name:BECEIRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3702 76TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-1212
Mailing Address - Country:US
Mailing Address - Phone:806-792-3251
Mailing Address - Fax:806-743-2893
Practice Address - Street 1:3601 4TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-3859
Practice Address - Country:US
Practice Address - Phone:806-743-3150
Practice Address - Fax:806-743-2893
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE1985207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX131475904Medicaid
NMV2274Medicaid
TX8049M0Medicare PIN
TX131475904Medicaid