Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | D60466 | MD |
N | 208600000X | Surgeon | D60466 | MD |
Y | 2086S0102X | Surgical Critical Care | Q4901 | TX |
N | 2086S0127X | Trauma Surgeon | Q4901 | TX |
NPI | 1205068111 |
---|---|
Provider Name | Dr. Tyson Erik Becker |
First Address | Silver Spring, MD 20910-4119 |
Second Address | Fort Sam Houston, TX 78234-4504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2009 |
Last Update Date | 12/06/2019 |