Individual
BENITO GABRIEL ENRIQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
530 SAN PEDRO AVE, SAN ANTONIO, TX 78212
(210) 225-4511
(210) 225-4514
Mailing address
2961 MOSSROCK, SAN ANTONIO, TX 78230-5119
(210) 731-4800
(210) 731-4810
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA02195
TX
Other
Enumeration date
12/23/2005
Last updated
03/20/2019
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