Healthcare Provider Details

I. General information

NPI: 1487637286
Provider Name (Legal Business Name): LISA A BECKER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2005
Last Update Date: 04/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7720 S BROADWAY STE 220
LITTLETON CO
80122-2632
US

IV. Provider business mailing address

7720 S BROADWAY STE 220
LITTLETON CO
80122-2632
US

V. Phone/Fax

Practice location:
  • Phone: 720-528-0800
  • Fax: 720-528-0801
Mailing address:
  • Phone: 720-528-0800
  • Fax: 720-528-0801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35769
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number35769
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: