Individual
SANDRA LUCILLE BENAVIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
6621 FANNIN ST, MC 2-1450, HOUSTON, TX 77030
(832) 824-5703
Mailing address
1510 SHAMROCK LN, DEER PARK, TX 77536-3957
(281) 476-4611
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
561791
TX
Other
Enumeration date
04/09/2007
Last updated
07/08/2007
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