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NPI Code Detail

MEDICARE: DAVID BENITEZ

MEDICARE: DAVID BENITEZ
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
1207R00000XInternal Medicine PhysicianW2255TX

General Provider Information

NPI Number : 1396495818
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID BENITEZ
Provider Business Mailing Address
First Line : 103 PARK PL
Second Line :
City : PORTLAND
State : TX
Zip : 78374-1329
Country : US
Telephone Number : 951-454-6183
Fax Number :
Provider Business Practice Location Address
First Line : 2413 MEMORIAL PKWY
Second Line :
City : PORTLAND
State : TX
Zip : 78374-3209
Country : US
Telephone Number : 361-643-4546
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2022
Last Update Date : 12/01/2025

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Directions to “ DAVID BENITEZ ” Practice Location

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