Provider Demographics
NPI:1154646560
Name:ALEMU, BENYAM G (MD)
Entity Type:Individual
Prefix:DR
First Name:BENYAM
Middle Name:G
Last Name:ALEMU
Suffix:
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 1:790 GENERATIONS DR STE 205
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-0087
Mailing Address - Country:US
Mailing Address - Phone:830-351-5066
Mailing Address - Fax:830-351-5460
Practice Address - Street 1:790 GENERATIONS DR STE 205
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-0087
Practice Address - Country:US
Practice Address - Phone:830-351-5066
Practice Address - Fax:830-351-5460
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-30
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP6315208M00000X, 261QP2300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX340577109OtherCSHCN
TX340577108Medicaid
TX340577108Medicaid