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Organization
MICHAEL A BENAVIDES DO PA
Active
Organization
MICHAEL A BENAVIDES DO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL A BENAVIDES D.O. (PHYSICIAN, OWNER,PRESIDENT)
(972) 682-5757
Entity
Organization
Contact information
Practice address
1350 N BUCKNER BLVD, SUITE 101, DALLAS, TX 75218-3558
(972) 682-5757
(972) 682-6611
Mailing address
PO BOX 570543, DALLAS, TX 75357-0543
(972) 682-5757
(972) 682-6611
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
H6044
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3475816-01
—
TX
05
—
3475816-02
—
TX
Enumeration date
10/13/2009
Last updated
10/16/2015
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