Healthcare Provider Details

I. General information

NPI: 1023639200
Provider Name (Legal Business Name): SARA EUNICE BENITEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2020
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6560 FANNIN ST STE 802
HOUSTON TX
77030-2726
US

IV. Provider business mailing address

6560 FANNIN ST STE 802
HOUSTON TX
77030-2726
US

V. Phone/Fax

Practice location:
  • Phone: 713-363-9589
  • Fax:
Mailing address:
  • Phone: 713-363-7310
  • Fax: 713-790-5079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberV2439
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: