Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | M0014 | TX |
NPI | 1124037643 |
---|---|
Provider Name | Amy Michelle Becker |
First Address | Corpus Christi, TX 78411-1721 |
Second Address | Corpus Christi, TX 78411-1721 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 28/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1715815-06 | (05) | TX |