Provider Demographics
NPI:1538403068
Name:TERRAZAS-PONCE, BELEN (PNP-PC)
Entity type:Individual
Prefix:
First Name:BELEN
Middle Name:
Last Name:TERRAZAS-PONCE
Suffix:
Gender:F
Credentials:PNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7420 REMCON CIR STE A
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-3537
Mailing Address - Country:US
Mailing Address - Phone:915-532-8823
Mailing Address - Fax:915-225-2015
Practice Address - Street 1:7420 REMCON CIR STE A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-3537
Practice Address - Country:US
Practice Address - Phone:915-532-8823
Practice Address - Fax:915-532-5909
Is Sole Proprietor?:No
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX597176363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics