Provider Demographics
NPI:1043876089
Name:BENAVIDEZ SALDIVAR, ROSA N
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:N
Last Name:BENAVIDEZ SALDIVAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10650 CULEBRA RD STE 104-140
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4949
Mailing Address - Country:US
Mailing Address - Phone:210-583-4534
Mailing Address - Fax:
Practice Address - Street 1:9410 DUGAS DR STE 118
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245-1869
Practice Address - Country:US
Practice Address - Phone:210-447-7041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-15
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106S00000X
235Z00000X
TX118159235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician