Provider Demographics
NPI: | 1982234852 |
---|---|
Name: | BENSON, ADRIANA (PA) |
Entity type: | Individual |
Prefix: | |
First Name: | ADRIANA |
Middle Name: | |
Last Name: | BENSON |
Suffix: | |
Gender: | F |
Credentials: | PA |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | PO BOX 4767 |
Mailing Address - Street 2: | |
Mailing Address - City: | MCALLEN |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 78502-4767 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 956-362-5030 |
Mailing Address - Fax: | 956-362-5035 |
Practice Address - Street 1: | 1421 N COL ROWE BLVD STE A |
Practice Address - Street 2: | |
Practice Address - City: | MCALLEN |
Practice Address - State: | TX |
Practice Address - Zip Code: | 78501-2304 |
Practice Address - Country: | US |
Practice Address - Phone: | 956-362-5030 |
Practice Address - Fax: | 956-362-5035 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2020-01-20 |
Last Update Date: | 2021-12-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | PA12927 | 363A00000X, 207PE0004X, 251E00000X, 251G00000X, 363A00000X |
174H00000X, 247ZC0005X, 261Q00000X, 310400000X, 311500000X, 311Z00000X, 320700000X, 385H00000X | ||
TX | RCP00077263 | 227900000X, 332B00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | |
No | 174H00000X | Other Service Providers | Health Educator | |
No | 207PE0004X | Allopathic & Osteopathic Physicians | Emergency Medicine | Emergency Medical Services |
No | 227900000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | |
No | 247ZC0005X | Technologists, Technicians & Other Technical Service Providers | Technician, Pathology | Clinical Laboratory Director, Non-physician |
No | 251E00000X | Agencies | Home Health | |
No | 251G00000X | Agencies | Hospice Care, Community Based | |
No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | |
No | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility | |
No | 311500000X | Nursing & Custodial Care Facilities | Alzheimer Center (Dementia Center) | |
No | 311Z00000X | Nursing & Custodial Care Facilities | Custodial Care Facility | |
No | 320700000X | Residential Treatment Facilities | Residential Treatment Facility, Physical Disabilities | |
No | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | |
No | 385H00000X | Respite Care Facility | Respite Care |