Provider Demographics
NPI:1841813649
Name:BENEJAN GEIGEL, KRISTIE ZOE (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTIE
Middle Name:ZOE
Last Name:BENEJAN GEIGEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTIE
Other - Middle Name:ZOE
Other - Last Name:BENEJAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 202479
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-2479
Mailing Address - Country:US
Mailing Address - Phone:915-790-5700
Mailing Address - Fax:
Practice Address - Street 1:1521 JOE BATTLE BLVD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-6286
Practice Address - Country:US
Practice Address - Phone:915-790-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-27
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU5642207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine