IndividualActive
Benedict Novicio, CRNA
NPI 1003118654 · Certified Registered Nurse Anesthetist · Odessa, TX
Provider details
- NPI number
- 1003118654
- Entity type
- Individual
- Primary specialty
- Certified Registered Nurse AnesthetistPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CRNA
- Sex
- Male
- Sole proprietor
- Yes
- License
- 004588 (CT)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
500 W 4th St
Odessa, TX 79761-5001
Phone: (432) 640-2408
Fax: (432) 640-2190
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 2129
Odessa, TX 79760-2129
Registry dates
- Enumerated
- 2010-12-01
- Last updated
- 2015-10-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.