Basic Information
| Provider Information | |||||||||
| NPI: | 1467677930 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BENIGNO J FERNANDEZ, M.D., P.A. | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 90415 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782099084 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104953627 | ||||||||
| FaxNumber: | 2104913581 | ||||||||
| Practice Location | |||||||||
| Address1: | 17720 CORPORATE WOODS DR | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782593500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104953627 | ||||||||
| FaxNumber: | 2104913581 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2007 | ||||||||
| LastUpdateDate: | 03/18/2008 | ||||||||
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| AuthorizedOfficialLastName: | FERNANDEZ | ||||||||
| AuthorizedOfficialFirstName: | BENIGNO | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PSYCHIATRIST | ||||||||
| AuthorizedOfficialTelephone: | 2104953627 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 273R00000X | J0758 | TX | Y | Hospital Units | Psychiatric Unit |
No ID Information.