Basic Information
| Provider Information | |||||||||
| NPI: | 1962759597 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BENVENISTE | ||||||||
| FirstName: | ANA PAULA | ||||||||
| MiddleName: | AITHE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5212 WILLOW ST | ||||||||
| Address2: | |||||||||
| City: | BELLAIRE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774013933 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7136650075 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 BAYLOR PLZ | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770303411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137984417 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2012 | ||||||||
| LastUpdateDate: | 11/08/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | Q0868 | TX | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.