Individual
JACOB RAY BECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1600 WALLACE BLVD, AMARILLO, TX 79106-1799
(806) 212-2000
Mailing address
PO BOX 840853, DALLAS, TX 75284-2502
(972) 715-5000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN664861
PA
282N00000X
General Acute Care Hospital
912946
TX
367500000X
Certified Registered Nurse Anesthetist
116076
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
AP133544
TX
Other
Enumeration date
11/09/2016
Last updated
07/06/2020
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