=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215642087
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GRECIA MAGNOLIA BECKETT FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/17/2023
-----------------------------------------------------
Last Update Date | 07/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2701 US HIGHWAY 271 N
-----------------------------------------------------
City | PITTSBURG
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75686-4289
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-946-5000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2701 US HIGHWAY 271 N
-----------------------------------------------------
City | PITTSBURG
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75686-4289
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 239988
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 1191715
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------