Provider Demographics
NPI:1093254807
Name:BOX, BENJAMIN ALLEN (APRN)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:ALLEN
Last Name:BOX
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:MR
Other - First Name:BENJAMIN
Other - Middle Name:ALLEN
Other - Last Name:BOX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:37 BRUSHWOOD CT
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1508
Mailing Address - Country:US
Mailing Address - Phone:361-244-6497
Mailing Address - Fax:
Practice Address - Street 1:37 BRUSHWOOD CT
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1508
Practice Address - Country:US
Practice Address - Phone:361-244-6497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-14
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133070363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily