MEDICARE: OSIRIS ANDRES FERNANDEZ BETANCES MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program		AL
2	390200000X	Student in an Organized Health Care Education/Training Program		TX

General Provider Information

NPI Number	:	1386334571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OSIRIS ANDRES FERNANDEZ BETANCES MD

Provider Business Mailing Address
First Line	:	1530 3RD AVE S # ZRB624
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35294-0002
Country	:	US
Telephone Number	:	205-934-7023
Fax Number	:	205-934-7742

Provider Business Practice Location Address
First Line	:	2101 PEASE STREET, SUITE 200 VBMC - UTRGV IM
Second Line	:
City	:	HARLINGEN
State	:	TX
Zip	:	78550
Country	:	US
Telephone Number	:	956-296-1491
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2023
Last Update Date	:	06/09/2026

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