Provider Demographics
NPI:1679284277
Name:BELA, JOE
Entity Type:Individual
Prefix:MR
First Name:JOE
Middle Name:
Last Name:BELA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9830 MAGNOLIA RIVER
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-3299
Mailing Address - Country:US
Mailing Address - Phone:443-889-0030
Mailing Address - Fax:
Practice Address - Street 1:77 E COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2348
Practice Address - Country:US
Practice Address - Phone:702-524-4633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities