Provider Demographics
NPI:1699140996
Name:BENITEZ, RAMIRO (FNP)
Entity type:Individual
Prefix:
First Name:RAMIRO
Middle Name:
Last Name:BENITEZ
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 E SAN PATRICIO AVE
Mailing Address - Street 2:
Mailing Address - City:MATHIS
Mailing Address - State:TX
Mailing Address - Zip Code:78368-2350
Mailing Address - Country:US
Mailing Address - Phone:361-547-8079
Mailing Address - Fax:361-547-8086
Practice Address - Street 1:304 E SAN PATRICIO AVE
Practice Address - Street 2:
Practice Address - City:MATHIS
Practice Address - State:TX
Practice Address - Zip Code:78368-2350
Practice Address - Country:US
Practice Address - Phone:361-547-8079
Practice Address - Fax:361-547-8086
Is Sole Proprietor?:No
Enumeration Date:2015-12-11
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129242363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX468106YNNNOtherMEDICARE PTAN