Provider Demographics
NPI:1215768759
Name:BENAVIDES, VILMA (FNP)
Entity type:Individual
Prefix:
First Name:VILMA
Middle Name:
Last Name:BENAVIDES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6393 BABCOCK RD # 102
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-2516
Mailing Address - Country:US
Mailing Address - Phone:726-200-1725
Mailing Address - Fax:
Practice Address - Street 1:6393 BABCOCK RD # 102
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-2516
Practice Address - Country:US
Practice Address - Phone:726-200-1725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1157180363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily