Provider Demographics
NPI:1376656728
Name:BENNY, EDCHERIL (MD)
Entity Type:Individual
Prefix:DR
First Name:EDCHERIL
Middle Name:
Last Name:BENNY
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 1:2100 WEST LOOP S
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-3515
Mailing Address - Country:US
Mailing Address - Phone:713-590-2700
Mailing Address - Fax:713-590-2702
Practice Address - Street 1:2100 WEST LOOP S
Practice Address - Street 2:SUITE100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-3515
Practice Address - Country:US
Practice Address - Phone:713-590-2700
Practice Address - Fax:713-590-2702
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD00000309552084N0400X
TXN12602084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0191134OtherCIGNA
TN3106691OtherBCBS
TN3832217Medicaid
G28183Medicare UPIN
TN3832217Medicaid