Individual
ALICE BENNEFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
755 S BECKHAM AVE, TYLER, TX 75701-1903
(903) 534-4684
Mailing address
755 S BECKHAM AVE, TYLER, TX 75701-1903
(903) 534-4684
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
699520
TX
Other
Enumeration date
10/30/2019
Last updated
10/30/2019
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