| Jose B. Benigno Medical Clinic, P.a. | |
|
115 W 42nd St Odessa TX 79764-4001 | |
| (432) 367-4817 | |
| (432) 367-4813 |
| Full Name | Jose B. Benigno Medical Clinic, P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 115 W 42nd St, Odessa, Texas |
| Authorized Official Name and Position | Jose Bato Benigno (SECRETARY/PRESIDENT) |
| Authorized Official Contact | 4323674817 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jose B. Benigno Medical Clinic, P.a. 115 W 42nd St Odessa TX 79764-4001 Ph: (432) 367-4817 | Jose B. Benigno Medical Clinic, P.a. 115 W 42nd St Odessa TX 79764-4001 Ph: (432) 367-4817 |
| NPI Number | 1750666095 |
|---|---|
| Provider Enumeration Date | 10/19/2011 |
| Last Update Date | 10/19/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750666095 | NPI | - | NPPES |
| 171721701 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | K9021 (Texas) | Primary |
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