Provider Demographics
NPI:1083894521
Name:RENFRO, BENJAMIN DON (DC)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:DON
Last Name:RENFRO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7410 BLANCO RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-4363
Mailing Address - Country:US
Mailing Address - Phone:800-404-6050
Mailing Address - Fax:866-298-4032
Practice Address - Street 1:4725 DATAPOINT
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229
Practice Address - Country:US
Practice Address - Phone:800-404-6050
Practice Address - Fax:866-298-4032
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC10749111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor