Marco a Benitez Mdpa

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

L8616 Issued in TX

Legal business name

MARCO A BENITEZ MDPA

Practice address

511 Gaslight Blvd
Lufkin, TX 75904-3127

Phone

(936) 639-2222

Fax

(936) 639-8810

NPI assigned

Apr 2, 2008

Last updated

Apr 2, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Marco A Benitez, MDNPI 1013022979

Title

Physician/Owner

Phone

(936) 639-2222

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marco A Benitez, M.D

  • Neurology Physician
  • Lufkin, TX
  • NPI 1013022979
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207094400000",
    "number": "1780857417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 GASLIGHT BLVD",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043127",
            "telephone_number": "936-639-2222",
            "fax_number": "936-639-8810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 GASLIGHT BLVD",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043127",
            "telephone_number": "936-639-2222",
            "fax_number": "936-639-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARCO A BENITEZ MDPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-02",
        "last_updated": "2008-04-02",
        "status": "A",
        "authorized_official_last_name": "BENITEZ",
        "authorized_official_first_name": "MARCO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "936-639-2222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "L8616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Marie Malnar, MS, APRN, FNP-C
• Frederick Rosas Manalo, PT
• Yugandhar Reddy Manda, MD
• Vivek Mangla, M.D.
• Lauren Hudson Manley, FNP-C
• Margo Personal Care Enterprises Inc (Deep East Texas Community Services and Home Health Care)
• Dakota Marks
• Haley Marks
• Brent Curtis Martin
• James Rick Martin, D.O.

• Neurology Physician in Lufkin, TX
• Providers in Lufkin, TX by specialty
• Neurology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.