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General NPI Number Information
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NPI Number | 1205667011
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Entity Type | Organization
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Legal Business Name | BECK EYECARE 002 PLLC
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Dates
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Enumeration Date | 08/13/2024
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Last Update Date | 12/27/2024
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Provider Practice Location Address
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Address Line | 5609 JACKSON RD STE 104
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City | ANN ARBOR
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State | MI
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Zip | 48103-7259
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Country | US
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Telephone | 734-369-3215
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Fax |
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Provider Business Mailing Address
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Address Line | 47300 W 10 MILE RD
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City | NOVI
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State | MI
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Zip | 48374-2917
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Country | US
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Telephone | 248-782-2777
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Fax | 248-782-2999
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Authorized Official
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Title or Position | OWNER
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Name | DR. AUSTIN A KASHAT
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Credential | OD
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Telephone | 248-798-6493
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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