Organization
DERMATOLOGY AND SKIN CANCER CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN JOHN BECK MD (OWNER)
(903) 757-8878
Entity
Organization
Contact information
Practice address
901 WALNUT HILL DR, LONGVIEW, TX 75605-5054
(903) 757-8878
(903) 757-5985
Mailing address
901 WALNUT HILL DR, LONGVIEW, TX 75605-5054
(903) 757-8878
(903) 757-5985
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
F3749
TX
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
F3749
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00U13U
BLUE CROSS
TX
05
—
109529102
—
TX
01
—
CD8001
RAILROAD MEDCIARE
TX
Enumeration date
09/28/2006
Last updated
05/06/2008
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