Basic Information
Provider Information
NPI: 1033558317
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BECHER
FirstName: EMILY
MiddleName: B.
NamePrefix: MS.
NameSuffix:  
Credential: N.P.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 12221 MENT DRIVE
Address2: SUITE 1500
City: DALLAS
State: TX
PostalCode: 75251
CountryCode: US
TelephoneNumber: 2142342750
FaxNumber:  
Practice Location
Address1: 12221 MENT DRIVE
Address2: SUITE 1500
City: DALLAS
State: TX
PostalCode: 75251
CountryCode: US
TelephoneNumber: 2142342750
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/19/2013
LastUpdateDate: 06/30/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XAP123314TXY Nursing Service ProvidersRegistered Nurse 
363LF0000X688301TXN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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