Individual
DR. JOSE BATO BENIGNO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
115 W 42ND ST, ODESSA, TX 79764-4001
(432) 367-4817
(432) 367-4813
Mailing address
115 W 42ND ST, ODESSA, TX 79764-4001
(432) 367-4817
(432) 367-4813
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
K9021
TX
208000000X
Pediatrics Physician
K9021
TX
208D00000X
General Practice Physician
Primary
K9021
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
092555-04
—
TX
05
—
1717217-01
—
TX
05
—
1717217-02
—
TX
Enumeration date
10/13/2006
Last updated
06/26/2019
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