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General NPI Number Information
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NPI Number | 1376237420
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Entity Type | Individual
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Provider Name | KAYLA RENAY BELTRAN LMT
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Gender | Female
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Dates
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Enumeration Date | 06/02/2023
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Last Update Date | 06/02/2023
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Provider Practice Location Address
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Address Line | 5327 MCCULLOUGH AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78212
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Country | US
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Telephone | 210-802-6691
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Fax |
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Provider Business Mailing Address
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Address Line | 1618 SCHLEY AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78210-4355
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Country | US
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Telephone | 210-912-0662
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT122358
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License Number State | TX
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