Provider Demographics
NPI:1326153107
Name:BELTRAN, OSCAR R (LSA)
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:R
Last Name:BELTRAN
Suffix:
Gender:M
Credentials:LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 BINZ ST STE 1275
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-6937
Mailing Address - Country:US
Mailing Address - Phone:713-520-0658
Mailing Address - Fax:713-522-9618
Practice Address - Street 1:1200 BINZ ST STE 1275
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-6937
Practice Address - Country:US
Practice Address - Phone:713-520-0658
Practice Address - Fax:713-522-9618
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00162174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXSA00162OtherTX MED BOARD PERMIT NUM
TX8N4139OtherBLUE CROSS BLUE SHIELD OF TEXAS
TX8N4139OtherBLUE CROSS BLUE SHIELD OF TEXAS