Provider Demographics
NPI:1851407019
Name:BENENATE, JOSEPH F (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:F
Last Name:BENENATE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 820215
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75382-0215
Mailing Address - Country:US
Mailing Address - Phone:214-808-5775
Mailing Address - Fax:214-342-1847
Practice Address - Street 1:9627 ROBIN MEADOW DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-7522
Practice Address - Country:US
Practice Address - Phone:214-808-5775
Practice Address - Fax:214-342-1847
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2020-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2241207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121236701Medicaid
TXE43848Medicare UPIN
TXDL16Medicare ID - Type Unspecified