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General NPI Number Information
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NPI Number | 1659089142
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Entity Type | Individual
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Provider Name | DESIREE MARIE BECERRA
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Gender | Female
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Dates
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Enumeration Date | 11/14/2022
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 7200 SW 45TH AVE UNIT 14
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City | AMARILLO
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State | TX
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Zip | 79109-5084
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Country | US
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Telephone | 806-680-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 1205 23RD ST STE 6
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City | CANYON
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State | TX
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Zip | 79015-5331
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Country | US
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Telephone | 806-557-4674
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1088329
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License Number State | TX
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