Healthcare Provider Details

I. General information

NPI: 1760599831
Provider Name (Legal Business Name): OSCAR BENAVENTE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 07/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4647 MEDICAL DR
SAN ANTONIO TX
78229-4403
US

IV. Provider business mailing address

7703 FLOYD CURL DRIVE, MD 7883 UNIVERSITY OF TEXAS HEALTH SCIENTE CENTER SAN ANTONIO
SAN ANTONIO TX
78229-3900
US

V. Phone/Fax

Practice location:
  • Phone: 210-257-1400
  • Fax:
Mailing address:
  • Phone: 210-592-0400
  • Fax: 210-592-0552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberK7999
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: