Individual
MELISSA A BENAVIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1353 N WESTMORELAND RD, BLDG F, DALLAS, TX 75211-1655
(214) 333-7016
Mailing address
1353 N WESTMORELAND RD, BLDG F, DALLAS, TX 75211-1655
(214) 333-7016
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1072478
TX
2251P0200X
Pediatric Physical Therapist
Primary
1072478
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
063002201
—
TX
Enumeration date
12/20/2006
Last updated
12/10/2008
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