Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | C50469 | TX |
NPI | 1285062125 |
---|---|
Provider Name | James Beckham |
First Address | Houston, TX 77241-1364 |
Second Address | Houston, TX 77060-3410 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2013 |
Last Update Date | 09/04/2020 |