Provider Demographics
NPI:1922629526
Name:BELTRAN, CECILIA
Entity Type:Individual
Prefix:DR
First Name:CECILIA
Middle Name:
Last Name:BELTRAN
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 1:1762 NORTHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520
Mailing Address - Country:US
Mailing Address - Phone:956-755-7195
Mailing Address - Fax:
Practice Address - Street 1:AVENIDA MARGARITAS #11
Practice Address - Street 2:COLONIA JARDIN
Practice Address - City:H. MATAMOROS
Practice Address - State:TAMAULIPAS
Practice Address - Zip Code:87330
Practice Address - Country:MX
Practice Address - Phone:956-909-2543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2884750122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist