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General NPI Number Information
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NPI Number | 1912055674
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Entity Type | Individual
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Provider Name | LUIS REY BENAVIDES M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 500 W 4TH ST
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City | ODESSA
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State | TX
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Zip | 79761-5001
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Country | US
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Telephone | 432-640-2834
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Fax | 432-640-2834
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Provider Business Mailing Address
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Address Line | 2728 LOOP 337
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City | NEW BRAUNFELS
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State | TX
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Zip | 78130-8504
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Country | US
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Telephone | 830-609-0080
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Fax | 830-629-0416
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | M3809
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M3809
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License Number State | TX
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