Provider Demographics
NPI:1710240528
Name:BECKMAN, BRANDON ROBERT CURTIS (DO)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:ROBERT CURTIS
Last Name:BECKMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 SUNSET STRIP
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75402-3845
Mailing Address - Country:US
Mailing Address - Phone:903-454-2214
Mailing Address - Fax:
Practice Address - Street 1:2710 SUNSET STRIP
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75402-3845
Practice Address - Country:US
Practice Address - Phone:903-454-2214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ34612084P0804X
TXQ36412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3481764-01Medicaid
TXBP100037352OtherTEXAS PHYSICIAN IN TRAINING PERMIT NUMBER
TX3481764-01Medicaid