Provider Demographics
NPI:1851301360
Name:CRUZ-BECK, TERESA L (OTR)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:L
Last Name:CRUZ-BECK
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1490 E WHITESTONE BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-2274
Mailing Address - Country:US
Mailing Address - Phone:512-260-3300
Mailing Address - Fax:512-260-3343
Practice Address - Street 1:1490 E WHITESTONE BLVD
Practice Address - Street 2:STE 100
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2274
Practice Address - Country:US
Practice Address - Phone:512-260-3300
Practice Address - Fax:512-260-3343
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105338225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T6127OtherBCBS PROVIDER NO