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General NPI Number Information
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NPI Number | 1770851974
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Entity Type | Organization
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Legal Business Name | BECKEN VISION SOLUTIONS, PLLC
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Dates
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Enumeration Date | 12/02/2011
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Last Update Date | 12/02/2011
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Provider Practice Location Address
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Address Line | 21055 E RITTENHOUSE RD
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-4477
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Country | US
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Telephone | 480-457-1958
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Fax | 480-457-1960
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Provider Business Mailing Address
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Address Line | 18739 E BRAEBURN LN
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-6461
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Country | US
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Telephone | 480-282-1736
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Fax | 480-457-1960
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRANDON L BECKEN
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Credential | OD
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Telephone | 480-457-1958
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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 | 1635
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License Number State | AZ
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