Organization
CLINICA MEDICA DE DALLAS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENIGNO BUENTIPO JR. M.D. (VICE PRESIDENT)
(214) 823-5590
Entity
Organization
Contact information
Practice address
4811A COLUMBIA AVE, DALLAS, TX 75226-1034
(214) 823-5590
Mailing address
4811A COLUMBIA AVE, DALLAS, TX 75226-1034
(214) 823-5590
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/11/2006
Last updated
04/14/2008
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