Provider Demographics
NPI:1871844118
Name:NOVA BELTRAN PC
Entity Type:Organization
Organization Name:NOVA BELTRAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NOVA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELTRAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:281-866-8746
Mailing Address - Street 1:7611 SATSUMA ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77023-2738
Mailing Address - Country:US
Mailing Address - Phone:832-724-1902
Mailing Address - Fax:281-866-0858
Practice Address - Street 1:14340 TORREY CHASE BLVD
Practice Address - Street 2:STE. #155
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-1021
Practice Address - Country:US
Practice Address - Phone:281-866-8746
Practice Address - Fax:281-866-0858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-26
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64255101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty