Provider Demographics
NPI:1629820717
Name:FREDDE, BECCA DENISE
Entity Type:Individual
Prefix:
First Name:BECCA
Middle Name:DENISE
Last Name:FREDDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BECCA
Other - Middle Name:DENISE
Other - Last Name:MASSENGALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6931 DONEGAL DR
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801-0608
Mailing Address - Country:US
Mailing Address - Phone:661-699-2515
Mailing Address - Fax:
Practice Address - Street 1:3301 N 3RD ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79603-7054
Practice Address - Country:US
Practice Address - Phone:661-699-2515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other