Provider Demographics
NPI:1780751826
Name:BECK, DEANICE FAYE (MD)
Entity type:Individual
Prefix:DR
First Name:DEANICE
Middle Name:FAYE
Last Name:BECK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:13330 CALIFORNIA ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-5241
Mailing Address - Country:US
Mailing Address - Phone:402-392-1516
Mailing Address - Fax:402-392-3820
Practice Address - Street 1:13330 CALIFORNIA ST
Practice Address - Street 2:SUITE 110
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-5241
Practice Address - Country:US
Practice Address - Phone:402-392-1516
Practice Address - Fax:402-392-3820
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA48641208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation