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NPI Code Detail

MEDICARE: EKATERINA MIKHAILOVNA BELOUS MA

MEDICARE:   EKATERINA MIKHAILOVNA BELOUS  MA
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1548119779
Entity Type Code : Individual
Provider Name (Legal Business Name) : EKATERINA MIKHAILOVNA BELOUS MA
Provider Business Mailing Address
First Line : 805 N HAMPTON ST APT 5307
Second Line :
City : FORT WORTH
State : TX
Zip : 76102-1617
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1500 S MAIN ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-4917
Country : US
Telephone Number : 817-702-1100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2026
Last Update Date : 01/22/2026

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Directions to “ EKATERINA MIKHAILOVNA BELOUS MA” Practice Location

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