Provider Demographics
NPI:1316931439
Name:BECERRA, OSCAR DAVID (MD)
Entity type:Individual
Prefix:
First Name:OSCAR
Middle Name:DAVID
Last Name:BECERRA
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 1:808 N NOLAN RIVER RD
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-7012
Mailing Address - Country:US
Mailing Address - Phone:817-558-3937
Mailing Address - Fax:817-641-6424
Practice Address - Street 1:16130 JUAN HERNANDEZ DR STE 100
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-5541
Practice Address - Country:US
Practice Address - Phone:408-866-4000
Practice Address - Fax:650-934-2302
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC159108207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX116928604Medicaid
TX080163414OtherRAILROAD MEDICARE
TX116928603Medicaid
TX116928604Medicaid
TXF75666Medicare UPIN