Doctor Name: | GARY L. BECKER |
NPI Number: | 1023084639 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | E0804 |
Business Practice Address: | 6600 Fish Pond Rd Suite 201 Waco, TX - 767102581 |
Business Phone Number: | 2547529638 |
Business Fax Number: | 2547522201 |
Mailing Address: | 6600 Fish Pond Rd, Suite 201 WACO |
State: | TX |
Postal Code: | 767102581 |
Phone Number: | 2547529638 |
Fax Number: | 2547522201 |
NPI Enumeration Date: | 02/23/2006 |
NPI Last Update Date: | 12/29/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204C00000X |
License Number: | E0804 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Neuromusculoskeletal Medicine, Sports Medicine |
Taxonomy Specialization: | |
Taxonomy Definition: |