Healthcare Provider Details

I. General information

NPI: 1922629526
Provider Name (Legal Business Name): DR. CECILIA BELTRAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2020
Last Update Date: 05/05/2020
Certification Date: 05/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVENIDA MARGARITAS #11 COLONIA JARDIN
H. MATAMOROS TAMAULIPAS
87330
MX

IV. Provider business mailing address

1762 NORTHWOOD DR
BROWNSVILLE TX
78520
US

V. Phone/Fax

Practice location:
  • Phone: 956-909-2543
  • Fax:
Mailing address:
  • Phone: 956-755-7195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2884750
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: