Provider Demographics
NPI:1093973216
Name:BENEVIDES, RUI CARLOS II (MD)
Entity Type:Individual
Prefix:DR
First Name:RUI
Middle Name:CARLOS
Last Name:BENEVIDES
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13636 NOEL RD.
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240
Mailing Address - Country:US
Mailing Address - Phone:855-704-0283
Mailing Address - Fax:469-518-4827
Practice Address - Street 1:13636 NOEL RD.
Practice Address - Street 2:SUITE 1400
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240
Practice Address - Country:US
Practice Address - Phone:855-704-0283
Practice Address - Fax:469-518-4827
Is Sole Proprietor?:No
Enumeration Date:2008-05-23
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9155207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX199660502Medicaid
TX199660503Medicaid
TXTXB130739Medicare PIN
TX199660502Medicaid
TXTXB136120Medicare PIN