SearchTexas374J00000X

Benetta Mickens

NPI 1790693885 · on the registry since 2026 · sole proprietor

Practice

Address
2037 Spring Lake Rd
Waco, TX 76705
Phone
(254) 339-3831

Registry record

Primary taxonomy
374J00000X
374J00000X
Licence states on file
TX
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2026-08-31

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas