Healthcare Provider Details

I. General information

NPI: 1134149016
Provider Name (Legal Business Name): ORLANDO K. BECKUM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 10/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12307 COURTNEY GREENS RD
HOUSTON TX
77089-2585
US

IV. Provider business mailing address

12307 COURTNEY GREENS RD
HOUSTON TX
77089-2585
US

V. Phone/Fax

Practice location:
  • Phone: 832-362-9883
  • Fax:
Mailing address:
  • Phone: 832-362-9883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number19286
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License NumberP3121
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberP3121
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: