Healthcare Provider Details

I. General information

NPI: 1528510260
Provider Name (Legal Business Name): BEL ESC HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2016
Last Update Date: 03/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2304 W MICHIGAN AVE
MIDLAND TX
79701-5830
US

IV. Provider business mailing address

2304 W MICHIGAN AVE
MIDLAND TX
79701-5830
US

V. Phone/Fax

Practice location:
  • Phone: 432-695-6932
  • Fax: 800-708-5070
Mailing address:
  • Phone: 432-695-6932
  • Fax: 800-708-5070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateTX

VIII. Authorized Official

Name: MR. DOROTHY PAULINE MOORE
Title or Position: OWNER
Credential: NP
Phone: 713-893-4773