1841240215 NPI number — ROGER J BELBEL DO

Table of content: ROGER J BELBEL DO (NPI 1841240215)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841240215 NPI number — ROGER J BELBEL DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BELBEL
Provider First Name:
ROGER
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
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:
1841240215
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/14/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 836
Provider Second Line Business Mailing Address:
5 E7 ALVON ROAD
Provider Business Mailing Address City Name:
WHITE SULPHUR SPRINGS
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
24986-0836
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-536-5030
Provider Business Mailing Address Fax Number:
304-536-5031

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
935 SUNLAND PARK DR
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
EL PASO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79922-1369
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-231-2286
Provider Business Practice Location Address Fax Number:
915-231-2288
Provider Enumeration Date:
05/10/2006

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: 207RC0000X , with the licence number:  G9260 , 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: 1049504.05 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000B3941 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: G9260 . This is a "TX MEDICAL EXAMINER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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