Provider Demographics
NPI:1871732073
Name:BEICKER, AMY MARIE (PA)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:MARIE
Last Name:BEICKER
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 S MILAM ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-4789
Mailing Address - Country:US
Mailing Address - Phone:830-997-4043
Mailing Address - Fax:833-695-0415
Practice Address - Street 1:813 S MILAM ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-4789
Practice Address - Country:US
Practice Address - Phone:830-997-4043
Practice Address - Fax:833-695-0415
Is Sole Proprietor?:No
Enumeration Date:2009-02-11
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06100363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8Y9510OtherBCBS
TX8L13218Medicare PIN