Healthcare Provider Details

I. General information

NPI: 1619100104
Provider Name (Legal Business Name): REBECCA M BEYDA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA J MONK

II. Dates (important events)

Enumeration Date: 08/31/2009
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 E ROOSEVELT ST
PHOENIX AZ
85008-4948
US

IV. Provider business mailing address

4831 E ROBIN LN
PHOENIX AZ
85054-6166
US

V. Phone/Fax

Practice location:
  • Phone: 602-344-1095
  • Fax:
Mailing address:
  • Phone: 713-500-5663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number203238
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number80048
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberN9023
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: