Provider Demographics
NPI:1528243193
Name:BECK, JAY MORTIMER (MD)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:MORTIMER
Last Name:BECK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10978 CROOKED CREEK DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-4304
Mailing Address - Country:US
Mailing Address - Phone:214-691-6626
Mailing Address - Fax:214-691-6605
Practice Address - Street 1:10978 CROOKED CREEK DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229-4304
Practice Address - Country:US
Practice Address - Phone:214-691-6626
Practice Address - Fax:214-691-6605
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXC5602207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology