Provider Demographics
NPI:1568597391
Name:ALBRIGHT, BELINDA ELOISE
Entity Type:Individual
Prefix:MRS
First Name:BELINDA
Middle Name:ELOISE
Last Name:ALBRIGHT
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 1:7636 RED WILLOW RD
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76133-7571
Mailing Address - Country:US
Mailing Address - Phone:817-706-2409
Mailing Address - Fax:
Practice Address - Street 1:7636 RED WILLOW RD
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76133-7571
Practice Address - Country:US
Practice Address - Phone:817-294-5915
Practice Address - Fax:817-294-3742
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1195443747A0650X
310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000686300OtherDEPT AGED & DISABLED SVC
TX000686400OtherDEPT AGED & DISABLED SVC
TX0006864000Medicaid
TX000686300OtherRESPITE
TX000686400OtherCCAD
TX000686400OtherCBA
TX1554972362Medicaid