Organization
JOSE B. BENIGNO MEDICAL CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE BATO BENIGNO JR. M.D. (PRESIDENT / SECRETARY)
(432) 367-4817
Entity
Organization
Contact information
Practice address
115 W 42ND ST, ODESSA, TX 79764-4001
(432) 367-4817
Mailing address
115 W 42ND ST, ODESSA, TX 79764-4001
(432) 367-4817
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
K9021
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171721701
—
TX
05
—
171721702
—
TX
Enumeration date
10/13/2006
Last updated
11/05/2010
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