Basic Information
| Provider Information | |||||||||
| NPI: | 1508523978 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BELMARES | ||||||||
| FirstName: | ANTHONY | ||||||||
| MiddleName: | GEORGE | ||||||||
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| Credential: | APRN, CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24048 KUYKENDAHL ROAD | ||||||||
| Address2: | |||||||||
| City: | TOMBALL | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773755117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2812253897 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 24048 KUYKENDAHL ROAD | ||||||||
| Address2: | |||||||||
| City: | TOMBALL | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773755117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2812553897 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2021 | ||||||||
| LastUpdateDate: | 05/20/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 1059088 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.