1326153107 NPI number — OSCAR R BELTRAN L.S.A.

Table of content: OSCAR R BELTRAN L.S.A. (NPI 1326153107)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326153107 NPI number — OSCAR R BELTRAN L.S.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BELTRAN
Provider First Name:
OSCAR
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
L.S.A.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326153107
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/15/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1200 BINZ ST STE 1275
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77004-6937
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-520-0658
Provider Business Mailing Address Fax Number:
713-522-9618

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 BINZ ST STE 1275
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77004-6937
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-520-0658
Provider Business Practice Location Address Fax Number:
713-522-9618
Provider Enumeration Date:
08/20/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  SA00162 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: SA00162 . This is a "TX MED BOARD PERMIT NUM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8N4139 . This is a "BLUE CROSS BLUE SHIELD OF TEXAS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".