Provider Demographics
NPI:1982950622
Name:ZUNIGA, BENITO (FNP)
Entity Type:Individual
Prefix:MR
First Name:BENITO
Middle Name:
Last Name:ZUNIGA
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 SANTA FE ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-2338
Mailing Address - Country:US
Mailing Address - Phone:361-884-9900
Mailing Address - Fax:361-884-9903
Practice Address - Street 1:1215 SANTA FE ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2338
Practice Address - Country:US
Practice Address - Phone:361-884-9900
Practice Address - Fax:361-884-9903
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP122133363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX366021YLPSOtherWELLMED PTAN
TX338112102Medicaid