Provider Demographics
NPI:1417583303
Name:SMITH-BELTRAN, GRETTA ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:GRETTA
Middle Name:ELIZABETH
Last Name:SMITH-BELTRAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GRETTA
Other - Middle Name:ELIZABETH
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:254-724-2111
Mailing Address - Fax:
Practice Address - Street 1:1009 ARBOR PARK DR
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-8196
Practice Address - Country:US
Practice Address - Phone:254-724-5437
Practice Address - Fax:254-933-4107
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU3657208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics