Provider Demographics
NPI:1396036851
Name:BENSON, ANASTASIA M (DO)
Entity Type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:M
Last Name:BENSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6301 GASTON AVE
Mailing Address - Street 2:SUITE 445
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-3922
Mailing Address - Country:US
Mailing Address - Phone:214-810-3553
Mailing Address - Fax:844-823-2616
Practice Address - Street 1:6301 GASTON AVE
Practice Address - Street 2:SUITE 445
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75214-3922
Practice Address - Country:US
Practice Address - Phone:214-810-3553
Practice Address - Fax:844-823-2616
Is Sole Proprietor?:No
Enumeration Date:2011-05-02
Last Update Date:2016-09-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXBP10039514207Q00000X
TXQ0005207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine