Individual
JACQUES BENUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11714 WILSON PARKE AVE STE 150, AUSTIN, TX 78726-4061
(512) 346-6611
(512) 406-6267
Mailing address
6210 E HWY 290, AUSTIN, TX 78723-1142
(512) 483-9596
(512) 406-6216
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
09645
RI
208000000X
Pediatrics Physician
Primary
R0192
TX
2080P0006X
Developmental - Behavioral Pediatrics Physician
R0192
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
370875201
—
TX
05
—
370875202
—
TX
05
—
7006151
—
RI
Enumeration date
05/20/2006
Last updated
08/09/2024
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