MEDICARE: JAVIER BENITEZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program	BP10071454	TX
2	208600000X	Surgery Physician	11344	GA

General Provider Information

NPI Number	:	1215550025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAVIER BENITEZ MD

Provider Business Mailing Address
First Line	:	UT AUSTIN DELL MEDICAL SCHOOL GENERAL SURGERY
Second Line	:	1500 RED RIVER ST.
City	:	AUSTIN
State	:	TX
Zip	:	78712
Country	:	US
Telephone Number	:	512-324-7390
Fax Number	:

Provider Business Practice Location Address
First Line	:	UT AUSTIN DELL MEDICAL SCHOOL GENERAL SURGERY
Second Line	:	1500 RED RIVER ST.
City	:	AUSTIN
State	:	TX
Zip	:	78712
Country	:	US
Telephone Number	:	512-324-7390
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2020
Last Update Date	:	06/05/2026

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