Healthcare Provider Details

I. General information

NPI: 1679339527
Provider Name (Legal Business Name): MARIA BETANCOURT DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2024
Last Update Date: 03/04/2024
Certification Date: 03/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 WILDROSE LN
BROWNSVILLE TX
78520-8600
US

IV. Provider business mailing address

312 E HARRISON AVE STE A
HARLINGEN TX
78550-9136
US

V. Phone/Fax

Practice location:
  • Phone: 956-542-2845
  • Fax:
Mailing address:
  • Phone: 956-230-6121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: