NPI 1063490472 · live from the CMS NPI Registry
Stephen John Beck, MD
Dermatology, MOHS-Micrographic Surgery in Tyler, TX. National Provider Identifier 1063490472, active.
NPI record
| NPI | 1063490472 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dermatology, MOHS-Micrographic Surgery 207ND0101X |
| Practice location | 1367 Dominion Plz, Tyler, TX 75703 |
| Practice phone | 903-534-6200 |
| Mailing address | 901 Walnut Hill Dr, Longview, TX 75605 |
| Enumerated | January 5, 2006 |
| Last updated | July 30, 2015 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology, MOHS-Micrographic Surgery primary | 207ND0101X | F3749 (TX) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.