Benny Joe Lopez

Individual provider Active NPI Assisted Living Facility · Poteet, TX

NPI 1548726953 · NPPES record last updated Feb 11, 2019

Key facts

NPI
1548726953
Entity type
Individual (NPI type 1)
Primary specialty
Assisted Living Facility 310400000X
License
307105 (TX)
Practice address
309 Oak Creek Ests
Poteet, TX 78065-4019
Phone
(830) 276-4248
NPI assigned
Feb 11, 2019
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
307105TXMDAssisted Living Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Creek Estate Alf Assisted Living Facility Past
since Sep 29, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 307105 TX Yes

Addresses

Primary practice location

309 Oak Creek Ests
Poteet, TX 78065-4019

Mailing address

309 Oak Creek Ests
Poteet, TX 78065-4019

Other providers in Poteet, TX

All providers in Poteet, TX · Assisted Living Facility in Texas

Sources for this page

Verify at the official NPI Registry.