Individual
DIANA P BETANCOURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSFA
Contact information
Practice address
609 HODGES ST, LAKE CHARLES, LA 70601-4212
(407) 461-6953
Mailing address
609 HODGES ST, LAKE CHARLES, LA 70601-4212
(407) 461-6953
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
188425
TX
Other
Enumeration date
07/22/2022
Last updated
07/22/2022
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