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Individual

DR. MARISOL D. BENAVIDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
801 W. 1ST STREET, SAN JUAN, TX 78589
(956) 787-8915
(956) 787-2021
Mailing address
801 W. 1ST STREET, SAN JUAN, TX 78589-2276
(956) 787-8915
(956) 787-2021

Taxonomy

Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
M7855
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
297333101
TX
01
TXB142923
MEDICARE
TX
Enumeration date
10/04/2007
Last updated
08/31/2018
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