Individual
IDALIA IVANNA BENAVIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
161 TOMMINS AVE., SAN ANTONIO, TX 78214
(210) 924-9718
(210) 921-0807
Mailing address
161 TOMMINS AVE, SAN ANTONIO, TX 78214-1251
(210) 827-1223
(210) 921-0807
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
L6286
TX
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
L6286
TX
Other
Enumeration date
09/22/2006
Last updated
05/14/2026
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