Individual
SONIA LILIANA BETANCOURT CUELLAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
P O BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
P7882
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207935201
—
TX
01
—
207935202
CSHCN MEDICAID
TX
01
—
8W0998
BCBS
TX
01
—
P00774895
RAILROAD MEDICARE
—
Enumeration date
08/25/2009
Last updated
08/14/2020
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