Individual ProviderMelissa Ann BenavidesFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address333 N Santa Rosa St, Center For Children & Families, 4th Floor, Clinic A, San Antonio, TX 78207-3108(210) 704-8810PECOS EnrollmentBased on the most recent information from CMS, provider Melissa Ann Benavides does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1336221662Provider TypeIndividualFull NameBenavides, Melissa AnnCredentialM.D.GenderFemaleSole ProprietorNoEnumeration Date10/19/2006Last Updated3/26/2014Contact InformationPractice LocationPractice Address333 N Santa Rosa St, Center For Children & Families, 4th Floor, Clinic A, San Antonio, TX 78207-3108Phone(210) 704-8810Fax(210) 704-4136Mailing LocationMailing Address333 N Santa Rosa St, Center For Children & Families, 4th Floor, Clinic A, San Antonio, TX 78207-3108Phone(210) 704-8810Fax(210) 704-4136Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseK8608TexasProvider IdentifiersIDDescriptionIssuerID1249559-07DescriptionMedicaidIssuerUnlistedTexas