Provider Demographics
NPI:1922792308
Name:BELAY PHYSICIAN GROUP PLLC
Entity Type:Organization
Organization Name:BELAY PHYSICIAN GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTENEH
Authorized Official - Middle Name:
Authorized Official - Last Name:BELAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-888-8259
Mailing Address - Street 1:1233 YALE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-6959
Mailing Address - Country:US
Mailing Address - Phone:713-955-2665
Mailing Address - Fax:
Practice Address - Street 1:19143 W LAKE HOUSTON PKWY
Practice Address - Street 2:
Practice Address - City:ATASCOCITA
Practice Address - State:TX
Practice Address - Zip Code:77346-4800
Practice Address - Country:US
Practice Address - Phone:281-540-9113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-07
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty