Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 47316 | TX |
NPI | 1053516310 |
---|---|
Provider Name | Dr. Benedicto Cortes Baronia |
First Address | Lubbock, TX 79407 |
Second Address | Lubbock, TX 79415-3368 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2007 |
Last Update Date | 01/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
324777703 | (05) | TX |