Provider Demographics
NPI:1811124910
Name:BEICKER, CLINT ROYAL (MD)
Entity type:Individual
Prefix:
First Name:CLINT
Middle Name:ROYAL
Last Name:BEICKER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 W WINDCREST ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-4408
Mailing Address - Country:US
Mailing Address - Phone:830-997-4043
Mailing Address - Fax:830-997-0301
Practice Address - Street 1:813 S MILAM ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-4789
Practice Address - Country:US
Practice Address - Phone:830-997-4043
Practice Address - Fax:830-997-0301
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-16
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP2096207X00000X
TXBP10034018207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty