Provider Demographics
NPI:1891971313
Name:PATRICIA A BECKER MD
Entity Type:Organization
Organization Name:PATRICIA A BECKER MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-353-4800
Mailing Address - Street 1:1605 REDWOOD RD STE A
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-1424
Mailing Address - Country:US
Mailing Address - Phone:512-353-4800
Mailing Address - Fax:512-353-4805
Practice Address - Street 1:1605 REDWOOD RD STE A
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-1424
Practice Address - Country:US
Practice Address - Phone:512-353-4800
Practice Address - Fax:512-353-4805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX120355601Medicaid
TX120355603Medicaid
TX0038GNOtherBSBC TX