MEDICARE: OSCAR R BELTRAN L.S.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	SA00162	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SA00162	OTHER	TX	TX MED BOARD PERMIT NUM
2	8N4139	OTHER	TX	BLUE CROSS BLUE SHIELD OF TEXAS

General Provider Information

NPI Number	:	1326153107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OSCAR R BELTRAN L.S.A.

Provider Business Mailing Address
First Line	:	1200 BINZ ST STE 1275
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-6937
Country	:	US
Telephone Number	:	713-520-0658
Fax Number	:	713-522-9618

Provider Business Practice Location Address
First Line	:	1200 BINZ ST STE 1275
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-6937
Country	:	US
Telephone Number	:	713-520-0658
Fax Number	:	713-522-9618

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	02/15/2017

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Directions to “ OSCAR R BELTRAN L.S.A.” Practice Location

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