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Individual

DOMINIQUE BECK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1138 HOLLAND DR, GARLAND, TX 75040-9014
(214) 235-1986
Mailing address
1138 HOLLAND DR, GARLAND, TX 75040-9014
(214) 235-1986

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
3747P1801X
Personal Care Attendant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
15989
TX
05
3331281101
TX
Enumeration date
05/28/2019
Last updated
07/06/2019
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