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General NPI Number Information
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NPI Number | 1598544215
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Entity Type | Individual
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Provider Name | BRENDEN SHEA BECK OTR
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Gender | Male
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Dates
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Enumeration Date | 09/22/2023
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Last Update Date | 09/22/2023
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Provider Practice Location Address
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Address Line | 310 ODYSSEY DR
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City | WEBSTER
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State | TX
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Zip | 77598-1646
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Country | US
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Telephone | 281-480-5648
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Fax | 281-480-5691
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Provider Business Mailing Address
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Address Line | 3102 69TH ST APT 68
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City | GALVESTON
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State | TX
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Zip | 77551-2062
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Country | US
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Telephone | 325-280-2606
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 124069
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License Number State | TX
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