Provider Demographics
NPI:1629402177
Name:BENAVIDES, ARMINDA (OTR)
Entity Type:Individual
Prefix:MISS
First Name:ARMINDA
Middle Name:
Last Name:BENAVIDES
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:297 N TREVINOS ST
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-9568
Mailing Address - Country:US
Mailing Address - Phone:956-437-4143
Mailing Address - Fax:
Practice Address - Street 1:5346 E US HIGHWAY 83 STE 2
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-9418
Practice Address - Country:US
Practice Address - Phone:956-437-4143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-01
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114723225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist