MEDICARE: YAMIL BENECH JIMENEZ I FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP144143	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568988996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YAMIL BENECH JIMENEZ I FNP

Provider Business Mailing Address
First Line	:	8622 S BRAESWOOD BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77031-1301
Country	:	US
Telephone Number	:	281-909-0102
Fax Number	:	281-909-0105

Provider Business Practice Location Address
First Line	:	8622 S BRAESWOOD BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77031-1301
Country	:	US
Telephone Number	:	281-909-0102
Fax Number	:	281-909-0105

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2017
Last Update Date	:	01/07/2021

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Directions to “ YAMIL BENECH JIMENEZ I FNP” Practice Location

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