MARIE ANTOINETTE BENAVIDEZ (NPI# 1104309533) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104309533 |
| Entity Type | Individual |
| Full Name | MARIE ANTOINETTE BENAVIDEZ |
| Credential | CCP, LP |
| Practice Address |
3463 Magic Dr Ste T21 San Antonio TX 78229-3621 |
| Mailing Address |
1303 Kingbird Ct San Antonio TX 78245-4463 |
| Practice Telephone | 2122107123 |
| Mailing Telephone | 2107123710 |
| Enumeration Date | 2018-09-11 |
| Last Update Date | 2018-09-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 242T00000X | Perfusionist | FPF02000054 | TX | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
3463 MAGIC DR STE T21 |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78229-3621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154335792 | Santos Michael Rivera | Physician Assistant | 3463 Magic Dr Ste T21, San Antonio, TX 78229 | 2006-07-28 |
| 1629611231 | Hallie Ann Bell | Specialist/Technologist, Other | 3463 Magic Dr Ste T21, San Antonio, TX 78229-3621 | 2019-10-26 |
| 1750924874 | Amelia S Sanchez | Technician/Technologist | 3463 Magic Dr Ste T21, San Antonio, TX 78229-3621 | 2019-10-21 |
| 1013472802 | Betsy Tanner | Nurse Practitioner | 3463 Magic Dr Ste T21, San Antonio, TX 78229-3621 | 2019-02-05 |
| 1952808644 | Roberta Schultz Tremper | Registered Nurse | 3463 Magic Dr Ste T21, San Antonio, TX 78229-3621 | 2018-04-09 |
| 1861992117 | Sp United, LLC | Physician Assistant | 3463 Magic Dr Ste T21, San Antonio, TX 78229-3621 | 2018-02-13 |
| 1659885705 | Eileen Carrillo | Surgery | 3463 Magic Dr Ste T21, San Antonio, TX 78229-3621 | 2017-11-28 |
| 1932610557 | Jackline Realynn Sanchez | Surgery | 3463 Magic Dr Ste T21, San Antonio, TX 78229-3621 | 2017-10-23 |
| 1548770977 | Fermin Elizalde Dominguez IIi | Registered Nurse | 3463 Magic Dr Ste T21, San Antonio, TX 78229-3621 | 2017-10-12 |
| 1700177722 | Joe Roger Reyes | Specialist | 3463 Magic Dr Ste T21, San Antonio, TX 78229-3621 | 2011-04-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245857226 | Lyndsey A Sandoval | Optometrist | 7400 Minton Miner St, San Antonio, TX 78229 | 2020-06-25 |
| 1295355311 | Nicolet Finger | Student in an Organized Health Care Education/Training Program | 7703 Floyd Curl Drive, Mc 7798, San Antonio, TX 78229 | 2020-04-18 |
| 1215557400 | Amy Elizabeth Werry | Clinical Neuropsychologist | 7703 Floyd Circle Drive, San Antonio, TX 78229 | 2020-04-17 |
| 1740822972 | Mohammad Safaie Yazdi | Student in an Organized Health Care Education/Training Program | Ut Health Science Center At San Antonio- Agdc, 8210 Floyd Curl Dr., Msc 8103, San Antonio, TX 78229 | 2019-10-09 |
| 1063053072 | Blas Edward Villa | Nurse Practitioner | 7703 Floyd Curl Drive Mc 7885 Pulmonary Diseases & Crit, Medicine, San Antonio, TX 78229 | 2019-10-01 |
| 1124673942 | Integrity Dme Services LLC | Durable Medical Equipment & Medical Supplies | 6323 Sovereign Dr, Suite # 170 Ab, San Antonio, TX 78229 | 2019-08-08 |
| 1730734120 | Marisa Erin Leyden | Speech-Language Pathologist | Joe R. & Teresa Lozano Long Campus, 7703 Floyd Curl Dr., San Antonio, TX 78229 | 2019-08-03 |
| 1285295741 | Alireza Ghezavati | Student in an Organized Health Care Education/Training Program | 7703 Floyd Curl Drive Mc 7750, Department of Pathology and Laboratory Medicine, San Antonio, TX 78229 | 2019-06-25 |
| 1407410285 | Denae Cheyenne Rushing | Student in an Organized Health Care Education/Training Program | 8201 Floyd Curl Drive, San Antonio, TX 78229 | 2019-04-26 |
| 1265993570 | Shehzad Amlani | Student in an Organized Health Care Education/Training Program | Address: 7703 Floyd Curl Dr, San Antonio, TX 78229 | 2019-03-28 |
| Find all providers in zip 78229 | ||||
| Taxonomy Code | 242T00000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Perfusionist |
| A perfusionist operates extracorporeal circulation and autotransfusion equipment during any medical situation where it is necessary to support or temporarily replace the patient’s circulatory or respiratory function. The perfusionist is knowledgeable concerning the variety of equipment available to perform extracorporeal circulation functions and is responsible, in consultation with the physician, for selecting the appropriate equipment and techniques to be used. |
| Notes: Source: Health Professions Career and Education Directory, American Medical Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356865109 | Dauvon Lamar Mccormick | Perfusionist | 14603 Huebner Rd. Blg 28, Ste 28101, San Antonio, TX 78203 | 2017-08-02 |
| 1649653288 | Regina Giannola | Perfusionist | 6742 Manor Hill Dr., San Antonio, TX 78247 | 2015-07-01 |
| 1386064202 | Sandra Powell Melchor | Perfusionist | 8518 Shooting Quail, San Antonio, TX 78250-4613 | 2014-04-17 |
| 1891065793 | Haven Allan Young | Perfusionist | 1331 S Flores St, 308, San Antonio, TX 78204-1655 | 2012-01-09 |
| 1336455039 | Shelby Mcneel Miller | Perfusionist | 210 Halcyon Pl, San Antonio, TX 78209-3825 | 2010-08-19 |
| 1124202767 | Alaeddin M. Taher | Perfusionist | 622 Mathis Mdw, San Antonio, TX 78251-4344 | 2007-12-18 |
| 1265554414 | Robert Matthew Browne | Perfusionist | 14603 Huebner Rd Bldg 28, Ste. 28101, San Antonio, TX 78230-5497 | 2007-04-06 |
| 1467074674 | Tyrone Lamar Crews | Perfusionist | 14603 Huebner Rd Ste 28101, San Antonio, TX 78230-5497 | 2020-05-11 |
| 1164042776 | Amy Jo Walker | Perfusionist | 14603 Huebner Rd Ste 28101, San Antonio, TX 78230-5497 | 2020-04-23 |
| 1457970972 | Erica Ryu Ellsworth | Perfusionist | 14603 Huebner Rd Bldg 28, San Antonio, TX 78230-5497 | 2020-04-14 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78229 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.