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General NPI Number Information
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NPI Number | 1437947181
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Entity Type | Individual
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Provider Name | SAMUEL BECKETT APRN-CNP
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Gender | Male
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Dates
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Enumeration Date | 04/30/2025
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 8715 VILLAGE DR STE 518
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City | SAN ANTONIO
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State | TX
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Zip | 78217-5423
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Country | US
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Telephone | 210-590-7712
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Fax |
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Provider Business Mailing Address
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Address Line | 227 KAREN LN
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City | SAN ANTONIO
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State | TX
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Zip | 78209-4915
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Country | US
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Telephone | 772-532-0072
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1190988
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1190988
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License Number State | TX
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