Provider Demographics
NPI:1740501428
Name:BENITEZ, ENJOLI (MD MPH)
Entity type:Individual
Prefix:
First Name:ENJOLI
Middle Name:
Last Name:BENITEZ
Suffix:
Gender:F
Credentials:MD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 HAHLO ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77020-3022
Mailing Address - Country:US
Mailing Address - Phone:713-674-3326
Mailing Address - Fax:
Practice Address - Street 1:424 HAHLO ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77020-3022
Practice Address - Country:US
Practice Address - Phone:713-674-3326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-17
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5511207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine