Provider Demographics
NPI:1740587211
Name:DIAGO BENJUMEA, JAVIER ANDRES (MD)
Entity Type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:ANDRES
Last Name:DIAGO BENJUMEA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 E 7TH ST STE 700
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-3218
Mailing Address - Country:US
Mailing Address - Phone:346-639-3500
Mailing Address - Fax:
Practice Address - Street 1:1214 N POST OAK RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-7271
Practice Address - Country:US
Practice Address - Phone:346-639-3500
Practice Address - Fax:346-800-7094
Is Sole Proprietor?:No
Enumeration Date:2011-02-18
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP3143207Q00000X
FLME134231207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX331229YXEWMedicare PIN