Individual
LUCY MAE BENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5917 CROSSTOWN EXPRESSWAY SH 286, CORPUS CHRISTI, TX 78417
(361) 854-0811
(361) 806-5040
Mailing address
5917 CROSSTOWN EXPRESSWAY SH 286, CORPUS CHRISTI, TX 78417
(361) 854-0811
(361) 806-5040
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9113590
FL
363AM0700X
Medical Physician Assistant
Primary
PA15351
TX
363AS0400X
Surgical Physician Assistant
PA15351
TX
363AS0400X
Surgical Physician Assistant
PA9113590
FL
Other
Enumeration date
09/28/2020
Last updated
01/28/2025
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