Provider Demographics
NPI:1639472210
Name:GERMAN BENAVIDES, M.D., P.A.
Entity Type:Organization
Organization Name:GERMAN BENAVIDES, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GERMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BENAVIIDES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-922-3076
Mailing Address - Street 1:7333 BARLITE BLVD STE 310
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-1324
Mailing Address - Country:US
Mailing Address - Phone:210-922-3076
Mailing Address - Fax:210-922-2672
Practice Address - Street 1:7333 BARLITE BLVD STE 310
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1324
Practice Address - Country:US
Practice Address - Phone:210-922-3076
Practice Address - Fax:210-922-2672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-21
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0877207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB21189Medicare UPIN