Provider Demographics
NPI:1891769543
Name:BECKER, TARA P (MD)
Entity type:Individual
Prefix:DR
First Name:TARA
Middle Name:P
Last Name:BECKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6091 S KALISPELL ST
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80016-4749
Mailing Address - Country:US
Mailing Address - Phone:303-408-2088
Mailing Address - Fax:
Practice Address - Street 1:2055 HIGH ST
Practice Address - Street 2:SUITE 230
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5503
Practice Address - Country:US
Practice Address - Phone:303-860-9990
Practice Address - Fax:303-839-7761
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-16
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO40085207V00000X, 207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO100508748Medicaid
CO102068Medicare ID - Type Unspecified
CO100508748Medicaid