Individual
TODD P BELOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1208 MEDICAL PLAZA CT, GRANBURY, TX 76048-5653
(817) 579-7562
(817) 579-7592
Mailing address
1208 MEDICAL PLAZA CT, GRANBURY, TX 76048-5653
(817) 579-7562
(817) 579-7592
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
K2146
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1555266
—
LA
05
—
366370001
—
TX
Enumeration date
07/25/2006
Last updated
09/10/2020
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