Healthcare Provider Details

I. General information

NPI: 1649430265
Provider Name (Legal Business Name): CLAUDIA BENAVIDES RENDON LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CLAUDIA BENAVIDES

II. Dates (important events)

Enumeration Date: 06/17/2008
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 CRYSTAL CITY HWY
UVALDE TX
78801-6124
US

IV. Provider business mailing address

819 WATER ST 300
KERRVILLE TX
78028-5333
US

V. Phone/Fax

Practice location:
  • Phone: 830-278-1243
  • Fax: 830-278-1243
Mailing address:
  • Phone: 830-258-5430
  • Fax: 830-792-5771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number198789
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: