Domonique Shantae Beckham, PT, DPT
Physical Therapist in Boerne, TX. Individual provider (NPI-1).
NPI number1780152272
StatusActive
Last updated in NPPESAug 15, 2022
Details
- NPI
- 1780152272
- Entity type
- Individual (NPI-1)
- Name
- Domonique Shantae Beckham
- Credential
- PT, DPT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 2, 2018
- Certification date
- Aug 15, 2022
- Last updated
- Aug 15, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 1359208 | TX | Yes |
| 225100000X | Physical Therapist | 11-07109 | KS | |
| 225100000X | Physical Therapist | PT013764 | GA |
Practice location
138 Old San Antonio Rd Ste 304Boerne, TX 78006-3491
Phone 210-419-3144 · Fax 210-764-5098
Mailing address
1200 Corporate Dr Ste 400Hoover, AL 35242-5424
Phone 423-238-7217
Other practice locations
3627 Se 29th St Ste 107
Topeka, KS 66605-2013
Topeka, KS 66605-2013
Phone 785-266-4600 · Fax 785-266-4601
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