Healthcare Provider Details

I. General information

NPI: 1295481075
Provider Name (Legal Business Name): JOSHUA BECKER PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2022
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8140 WALNUT HILL LN STE 440
DALLAS TX
75231-4396
US

IV. Provider business mailing address

8140 WALNUT HILL LN STE 440
DALLAS TX
75231-4396
US

V. Phone/Fax

Practice location:
  • Phone: 214-857-0534
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number38291
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number38921
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: