Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | AP142875 | TX |
NPI | 1023667185 |
---|---|
Provider Name | Ms. Kristin Becker |
First Address | Houston, TX 77094-1399 |
Second Address | Houston, TX 77094-1399 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2019 |
Last Update Date | 10/09/2019 |