Organization
DERMATOLOGY AND SKIN CANCER CLINIC PA
Active
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
Update your record
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