Healthcare Provider Details

I. General information

NPI: 1568341386
Provider Name (Legal Business Name): EMBERLY STAR BENITEZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9900 MEMORIAL DR APT 319900
HOUSTON TX
77024-3423
US

IV. Provider business mailing address

9900 MEMORIAL DR APT 31
HOUSTON TX
77024-3433
US

V. Phone/Fax

Practice location:
  • Phone: 832-407-8284
  • Fax:
Mailing address:
  • Phone: 832-407-8284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number1065386
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code163WR0400X
TaxonomyRehabilitation Registered Nurse
License Number1065386
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: