Provider Demographics
NPI:1568988996
Name:BENECH JIMENEZ, YAMIL I (FNP)
Entity Type:Individual
Prefix:
First Name:YAMIL
Middle Name:
Last Name:BENECH JIMENEZ
Suffix:I
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8622 S BRAESWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77031-1301
Mailing Address - Country:US
Mailing Address - Phone:281-909-0102
Mailing Address - Fax:281-909-0105
Practice Address - Street 1:8622 S BRAESWOOD BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77031-1301
Practice Address - Country:US
Practice Address - Phone:281-909-0102
Practice Address - Fax:281-909-0105
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-17
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144143363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1215032602Medicaid
TX1801813704Medicaid
TX1861404691Medicaid
TX1801813704Medicaid