Provider Demographics
NPI:1215975487
Name:HELLERSTEDT, BETH ANN (MD)
Entity type:Individual
Prefix:DR
First Name:BETH
Middle Name:ANN
Last Name:HELLERSTEDT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-437-9605
Practice Address - Street 1:2410 ROUND ROCK AVE STE 150
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4019
Practice Address - Country:US
Practice Address - Phone:512-341-8724
Practice Address - Fax:512-687-0295
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6424207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8R1459OtherBLUE CROSS OF TEXAS
TX159313904Medicaid
TX159313905Medicaid
TX8R1459OtherBLUE CROSS OF TEXAS
TX159313904Medicaid
TX159313905Medicaid
TX8B1862Medicare PIN
TX8R1459OtherBLUE CROSS OF TEXAS
TX8D5728Medicare PIN
TXP00041733Medicare PIN
TX159313904Medicaid