MEDICARE: DR. JOSHUA BECKER PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103G00000X	Clinical Neuropsychologist	38291	TX
2	103TC0700X	Clinical Psychologist	38921	TX

General Provider Information

NPI Number	:	1295481075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSHUA BECKER PHD

Provider Business Mailing Address
First Line	:	8140 WALNUT HILL LN STE 440
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-4396
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8140 WALNUT HILL LN STE 440
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-4396
Country	:	US
Telephone Number	:	214-857-0534
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2022
Last Update Date	:	05/30/2024

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