Provider Demographics
NPI:1902364391
Name:BENECH JIMENEZ, LINO (FNP-C)
Entity Type:Individual
Prefix:
First Name:LINO
Middle Name:
Last Name:BENECH JIMENEZ
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8126 VISTA DEL SOL DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-5435
Mailing Address - Country:US
Mailing Address - Phone:713-754-0018
Mailing Address - Fax:
Practice Address - Street 1:11550 GULF FWY STE F
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034-3514
Practice Address - Country:US
Practice Address - Phone:713-944-0477
Practice Address - Fax:713-944-0491
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-05
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140872363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily