| Doctor Name: | BENITA AMIRMAZAHERI |
| NPI Number: | 1548583743 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 676122 |
| Business Practice Address: | 874 Ed Hall Dr Suite 102-103 Kaufman, TX - 751421861 |
| Business Phone Number: | 9729329345 |
| Business Fax Number: | |
| Mailing Address: | 628 Raintree Cir, COPPELL |
| State: | TX |
| Postal Code: | 750195447 |
| Phone Number: | 2142957586 |
| Fax Number: | |
| NPI Enumeration Date: | 03/02/2010 |
| NPI Last Update Date: | 03/02/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 676122 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |