Provider Demographics
NPI:1215642087
Name:BECKETT, GRECIA MAGNOLIA (RN)
Entity type:Individual
Prefix:
First Name:GRECIA
Middle Name:MAGNOLIA
Last Name:BECKETT
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:GRECIA
Other - Middle Name:MAGNOLIA
Other - Last Name:AMADOR PASTOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:111 PRIVATE ROAD 4742
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75455-1085
Mailing Address - Country:US
Mailing Address - Phone:903-563-5660
Mailing Address - Fax:
Practice Address - Street 1:2701 US HIGHWAY 271 N
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:TX
Practice Address - Zip Code:75686-4289
Practice Address - Country:US
Practice Address - Phone:903-946-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-17
Last Update Date:2025-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA239988363LF0000X
TX1191715363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily