Individual
ODELMAN BLANCO BENAVIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
18001 CYPRESS TRACE RD APT 3301, HOUSTON, TX 77090-1408
(832) 475-7498
Mailing address
18001 CYPRESS TRACE RD APT 3301, HOUSTON, TX 77090-1408
(832) 475-7498
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
17-546
WI
Other
Enumeration date
10/22/2017
Last updated
10/22/2017
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