Provider Demographics
NPI:1386239275
Name:PINEIRA, DAVID BENJAMIN
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:BENJAMIN
Last Name:PINEIRA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 RICHARD DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79907-2422
Mailing Address - Country:US
Mailing Address - Phone:915-777-9153
Mailing Address - Fax:
Practice Address - Street 1:824 RICHARD DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79907-2422
Practice Address - Country:US
Practice Address - Phone:915-777-9153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80634101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional