Provider Demographics
NPI:1619407921
Name:LOCURE, BENICIA
Entity Type:Individual
Prefix:
First Name:BENICIA
Middle Name:
Last Name:LOCURE
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 1:15226 ADDICKS STONE DR UNIT B
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-5077
Mailing Address - Country:US
Mailing Address - Phone:281-818-3246
Mailing Address - Fax:
Practice Address - Street 1:15226 ADDICKS STONE DR UNIT B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-5077
Practice Address - Country:US
Practice Address - Phone:281-818-3246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
821530863OtherNONE