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General NPI Number Information
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NPI Number | 1750797981
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Entity Type | Individual
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Provider Name | JENNIFER BELTRAN PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/09/2014
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Last Update Date | 08/19/2014
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Provider Practice Location Address
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Address Line | 800 W RANDOL MILL RD
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City | ARLINGTON
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State | TX
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Zip | 76012-2504
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Country | US
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Telephone | 210-842-2486
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Fax |
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Provider Business Mailing Address
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Address Line | 5016 RAYMOND DR
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City | FORT WORTH
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State | TX
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Zip | 76244-8019
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Country | US
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Telephone |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA09205
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License Number State | TX
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