Provider Demographics
NPI:1720375777
Name:BECKS MEDICAL GROUP INC
Entity Type:Organization
Organization Name:BECKS MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:UKACHI
Authorized Official - Middle Name:ONWERE
Authorized Official - Last Name:FADAKA
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:832-466-1631
Mailing Address - Street 1:10333 HARWIN DR
Mailing Address - Street 2:SUITE 235F
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-1545
Mailing Address - Country:US
Mailing Address - Phone:832-466-1631
Mailing Address - Fax:281-988-5519
Practice Address - Street 1:10333 HARWIN DR
Practice Address - Street 2:SUITE 235F
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-1545
Practice Address - Country:US
Practice Address - Phone:832-466-1631
Practice Address - Fax:281-988-5519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX570882363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty