Provider Demographics
NPI:1174500748
Name:SAN BENITO MEDICAL ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:SAN BENITO MEDICAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHACHERL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:956-247-7000
Mailing Address - Street 1:351 N SAM HOUSTON BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586-4696
Mailing Address - Country:US
Mailing Address - Phone:956-247-7000
Mailing Address - Fax:956-361-0854
Practice Address - Street 1:721 W HARRISON AVE
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-6016
Practice Address - Country:US
Practice Address - Phone:956-440-8470
Practice Address - Fax:956-399-6331
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAN BENITO MEDICAL ASSOCIATES, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-12-27
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121454601Medicaid
TX121454601Medicaid