Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | F2550 | TX |
N | 2080P0208X | Pediatric Infectious Diseases | F2550 | TX |
NPI | 1609873660 |
---|---|
Provider Name | Dr. William R Beck |
First Address | San Antonio, TX 78240-4106 |
Second Address | San Antonio, TX 78240-4106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3279995 | BLUELINK (01) | |
85271Y | BCBS (01) | |
E79995 | (02) |