Provider Demographics
NPI:1245214212
Name:BENGTSON, HANS ERIC (MD)
Entity Type:Individual
Prefix:DR
First Name:HANS
Middle Name:ERIC
Last Name:BENGTSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 343
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78292-0343
Mailing Address - Country:US
Mailing Address - Phone:830-627-3800
Mailing Address - Fax:830-625-2235
Practice Address - Street 1:4316 JAMES CASEY ST
Practice Address - Street 2:BLDG B, SUITE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1116
Practice Address - Country:US
Practice Address - Phone:512-498-1029
Practice Address - Fax:830-625-2235
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9852207LP2900X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX426688ZRZGMedicare PIN
TX203016502Medicaid
TXP00747728OtherRAILROAD MEDICARE
TX2030165-01Medicaid
TXTXB146752Medicare PIN
TXH82414Medicare UPIN
TX8K8396Medicare PIN
TX203016503Medicaid
TXTXB146756Medicare PIN