Individual
DR. MIGUEL ANGEL BENAVIDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT, ED.D
Contact information
Practice address
1001 E UNIVERSITY AVE, GEORGETOWN, TX 78626-6100
(512) 863-6511
Mailing address
1001 E UNIVERSITY AVE, GEORGETOWN, TX 78626-6100
(512) 863-6511
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0794
TX
Other
Enumeration date
10/27/2011
Last updated
10/27/2011
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