MEDICARE: JORDAN ALEIGH BECKHAM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA19674	TX

General Provider Information

NPI Number	:	1871454108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDAN ALEIGH BECKHAM

Provider Business Mailing Address
First Line	:	PO BOX 844658
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-4658
Country	:	US
Telephone Number	:	800-994-0371
Fax Number	:	254-215-9722

Provider Business Practice Location Address
First Line	:	302 UNIVERSITY BLVD
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78665-1032
Country	:	US
Telephone Number	:	512-509-0200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2025
Last Update Date	:	04/30/2026

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Directions to “ JORDAN ALEIGH BECKHAM ” Practice Location

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