Provider Demographics
NPI:1528582632
Name:BECKSTEAD, PATRICIA (DC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:BECKSTEAD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:CONTRAVEOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5545 MOUNTAIN VISTA ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-2114
Mailing Address - Country:US
Mailing Address - Phone:702-898-1400
Mailing Address - Fax:702-898-1485
Practice Address - Street 1:5545 MOUNTAIN VISTA ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-2114
Practice Address - Country:US
Practice Address - Phone:702-898-1400
Practice Address - Fax:702-898-1485
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB-572111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor