Healthcare Provider Details

I. General information

NPI: 1497149595
Provider Name (Legal Business Name): KENDRA LEE WILLIAMS BENESKI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KENDRA LEE WILLIAMS M.D.

II. Dates (important events)

Enumeration Date: 03/26/2015
Last Update Date: 10/07/2020
Certification Date: 10/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4032 MCDERMOTT RD STE 100
PLANO TX
75024-7739
US

IV. Provider business mailing address

1935 MEDICAL DISTRICT DR
DALLAS TX
75235-7701
US

V. Phone/Fax

Practice location:
  • Phone: 972-769-9000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberS5558
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: