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General NPI Number Information
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NPI Number | 1902109945
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Entity Type | Organization
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Legal Business Name | BENJAMIN INTERIANO M.D. P.A.
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Dates
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Enumeration Date | 12/14/2010
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Last Update Date | 10/27/2011
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Provider Practice Location Address
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Address Line | 7737 SOUTHWEST FWY SUITE 640
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City | HOUSTON
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State | TX
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Zip | 77074-1807
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Country | US
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Telephone | 713-988-1699
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Fax | 713-988-4892
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Provider Business Mailing Address
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Address Line | 7737 SOUTHWEST FWY SUITE 640
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City | HOUSTON
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State | TX
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Zip | 77074-1807
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Country | US
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Telephone | 713-988-1699
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Fax | 713-988-4892
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. RITA INTERIANO
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Credential |
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Telephone | 713-988-1699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | H6858
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License Number State | TX
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