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1306945415
IDALIA IVANNA BENAVIDES
SAN ANTONIO, TX
NPI
1306945415
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
174400000X Specialist
(Licence: TX L6286)
Enumeration Date
2006-09-22
Last Update Date
2010-06-14
Business Address
-- IDALIA IVANNA BENAVIDES M.D.
161 TOMMINS AVE.
SAN ANTONIO, TX 78214
Phone number: 210-924-9718
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Mailing Address
-- IDALIA IVANNA BENAVIDES M.D.
161 TOMMINS AVE
SAN ANTONIO, TX 78214-1251
Phone number: 210-827-1223
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