Provider Demographics
NPI:1952150435
Name:BEL-AIR FAMILY HEALTHCARE CLINIC
Entity type:Organization
Organization Name:BEL-AIR FAMILY HEALTHCARE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CEPEDA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:214-449-0274
Mailing Address - Street 1:4704 STRICKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-2012
Mailing Address - Country:US
Mailing Address - Phone:214-449-6601
Mailing Address - Fax:
Practice Address - Street 1:5910 PAIGE RD STE D
Practice Address - Street 2:
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-2143
Practice Address - Country:US
Practice Address - Phone:214-449-0274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-16
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty