Basic Information
Provider Information
NPI: 1235313321
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BECKER
FirstName: JOSEPH
MiddleName: RICHARD
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1303 MCCULLOUGH AVE
Address2: SUITE 374
City: SAN ANTONIO
State: TX
PostalCode: 782125615
CountryCode: US
TelephoneNumber: 2102235483
FaxNumber: 2102235492
Practice Location
Address1: 1303 MCCULLOUGH AVE
Address2: SUITE 374
City: SAN ANTONIO
State: TX
PostalCode: 782125615
CountryCode: US
TelephoneNumber: 2102235483
FaxNumber: 2102235492
Other Information
ProviderEnumerationDate: 12/26/2007
LastUpdateDate: 11/26/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RE0101XA103269CAN Allopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
207RE0101XN4939TXY Allopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism

No ID Information.


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