Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | E3648 | TX |
NPI | 1003810854 |
---|---|
Provider Name | Dr. Jaime Benrey |
First Address | Houston, TX 77030-2335 |
Second Address | Houston, TX 77030-2335 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2005 |
Last Update Date | 16/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C13368 | (02) |