Provider Demographics
NPI:1740280999
Name:BECK, KEITH (MD)
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:
Last Name:BECK
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 1:7579 N LOOP 1604 W
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-2781
Mailing Address - Country:US
Mailing Address - Phone:210-695-1900
Mailing Address - Fax:210-695-1901
Practice Address - Street 1:7579 N LOOP 1604 W
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-2781
Practice Address - Country:US
Practice Address - Phone:210-695-1900
Practice Address - Fax:210-695-1901
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG0607207PE0004X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC13305Medicare UPIN