Provider Demographics
NPI:1154681252
Name:MBUBIT, BELVINE
Entity Type:Individual
Prefix:
First Name:BELVINE
Middle Name:
Last Name:MBUBIT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10807 PERRIN BEITEL RD STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-3144
Mailing Address - Country:US
Mailing Address - Phone:210-245-7862
Mailing Address - Fax:210-245-7951
Practice Address - Street 1:10807 PERRIN BEITEL RD STE 300
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-3144
Practice Address - Country:US
Practice Address - Phone:210-245-7862
Practice Address - Fax:210-245-7951
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-22
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
TX1087271363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No251E00000XAgenciesHome Health