Benjamin Fano Md Pa | |
1616 Stonegate Dr Mission TX 78574-2764 | |
(956) 624-7187 | |
Not Available |
Full Name | Benjamin Fano Md Pa |
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Speciality | Internal Medicine |
Location | 1616 Stonegate Dr, Mission, Texas |
Authorized Official Name and Position | Benjamin Fano (OWNER) |
Authorized Official Contact | 9566247187 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Benjamin Fano Md Pa 1616 Stonegate Dr Mission TX 78574-2764 Ph: () - | Benjamin Fano Md Pa 1616 Stonegate Dr Mission TX 78574-2764 Ph: (956) 624-7187 |
NPI Number | 1881988061 |
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Provider Enumeration Date | 06/05/2011 |
Last Update Date | 06/05/2011 |
Medicare PECOS PAC ID | 2961676671 |
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Medicare Enrollment ID | O20111115000453 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881988061 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Benjamin Fano |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1952495400 PECOS PAC ID: 5890970909 Enrollment ID: I20110504000371 |
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