Individual
MS. JODIE BELTRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9398 VISCOUNT BLVD STE C, EL PASO, TX 79925-8056
(915) 594-1033
Mailing address
9398 VISCOUNT BLVD, STE C, EL PASO, TX 79925-8056
(915) 594-1033
(915) 594-1263
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA09802
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
353084201
—
TX
01
—
451648YLPS
WELLMED PTAN
TX
Enumeration date
07/23/2015
Last updated
11/27/2019
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