Individual
BENJAMIN ONTIVEROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
5001 N PIEDRAS ST, EL PASO, TX 79930-4210
(915) 256-4787
Mailing address
PO BOX 1312, CANUTILLO, TX 79835-1312
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1175447
TX
Other
Enumeration date
09/20/2024
Last updated
09/20/2024
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