MEDICARE: ANTONIA BENAVIDEZ FNP-BC

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	1087277	TX

General Provider Information

NPI Number	:	1922946060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTONIA BENAVIDEZ FNP-BC

Provider Business Mailing Address
First Line	:	810 ORANGE AVE
Second Line	:
City	:	WESLACO
State	:	TX
Zip	:	78596-7119
Country	:	US
Telephone Number	:	956-532-9744
Fax Number	:

Provider Business Practice Location Address
First Line	:	810 ORANGE AVE
Second Line	:
City	:	WESLACO
State	:	TX
Zip	:	78596-7119
Country	:	US
Telephone Number	:	956-532-9744
Fax Number	:

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

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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