1962149831 NPI number — MRS. HANNAH ELIZABETH PARKER BENAVIDEZ FNP-BC

Table of content: MRS. HANNAH ELIZABETH PARKER BENAVIDEZ FNP-BC (NPI 1962149831)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962149831 NPI number — MRS. HANNAH ELIZABETH PARKER BENAVIDEZ FNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BENAVIDEZ
Provider First Name:
HANNAH
Provider Middle Name:
ELIZABETH PARKER
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962149831
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/19/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
400 CONCORD PLAZA DR STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78216-6991
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-804-5416
Provider Business Mailing Address Fax Number:
210-678-4142

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19138 US HIGHWAY 281 N STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78258-4988
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-804-5400
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/12/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  1059316 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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