Individual
BENJAMIN FAVELA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
705 LLOYD AVE, FORT WORTH, TX 76103-3724
(682) 472-6622
Mailing address
705 LLOYD AVE, FORT WORTH, TX 76103-3724
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
113396
TX
Other
Enumeration date
03/30/2026
Last updated
03/30/2026
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