MEDICARE: MELISSA ANN BECK M.A., CCC-A

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	231H00000X	Audiologist	50973	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	80384A	OTHER	TX	BLUE SHIELD PROVIDER I D

General Provider Information

NPI Number	:	1790890283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA ANN BECK M.A., CCC-A

Provider Business Mailing Address
First Line	:	3636 W DALLAS ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77019-1704
Country	:	US
Telephone Number	:	713-523-3633
Fax Number	:	713-523-8399

Provider Business Practice Location Address
First Line	:	3636 W DALLAS ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77019-1704
Country	:	US
Telephone Number	:	713-523-3633
Fax Number	:	713-523-8399

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

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	07/08/2007

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