Provider Demographics
NPI:1972106318
Name:BECKWITH, KATHERINE MARGARET (AUD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:MARGARET
Last Name:BECKWITH
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 SPICEWOOD SPRINGS RD
Mailing Address - Street 2:BLDG 2, SUITE 100
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759
Mailing Address - Country:US
Mailing Address - Phone:512-345-4664
Mailing Address - Fax:
Practice Address - Street 1:330 CAMDEN CAUSEWAY
Practice Address - Street 2:SUITE D
Practice Address - City:CAMDEN
Practice Address - State:NC
Practice Address - Zip Code:27921
Practice Address - Country:US
Practice Address - Phone:252-331-2437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81418231H00000X
NC14266231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1306085410OtherBLUE CROSS BLUE SHIELD