Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | L7661 | TX |
NPI | 1033179262 |
---|---|
Provider Name | Dr. Richard Beckendorf |
First Address | Dallas, TX 75284-4658 |
Second Address | Temple, TX 76508-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 07/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1702391-02 | (05) | TX |
1702391-03 | CSHCN (01) | TX |
8S1908 | BLUE SHIELD (01) | TX |
H65162 | (02) | TX |