Provider Demographics
NPI:1417144924
Name:BENSON, SAMUEL EDWARD III (EMT)
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:EDWARD
Last Name:BENSON
Suffix:III
Gender:M
Credentials:EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205 W JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-7244
Mailing Address - Country:US
Mailing Address - Phone:956-457-8343
Mailing Address - Fax:610-401-2100
Practice Address - Street 1:1211 E PECAN BLVD STE 5
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-5718
Practice Address - Country:US
Practice Address - Phone:956-457-8343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-28
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
335G00000X, 146D00000X, 172A00000X, 177F00000X, 261QC1800X, 332B00000X, 3416S0300X, 343800000X, 343900000X, 347B00000X, 347C00000X, 347E00000X
TX153978146N00000X
TX772632279P3900X
TX800218341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335G00000XSuppliersMedical Foods Supplier
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No172A00000XOther Service ProvidersDriver
No177F00000XOther Service ProvidersLodging
No2279P3900XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredNeonatal/Pediatrics
No261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No341600000XTransportation ServicesAmbulance
No3416S0300XTransportation ServicesAmbulanceWater Transport
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347B00000XTransportation ServicesBus
No347C00000XTransportation ServicesPrivate Vehicle
No347E00000XTransportation ServicesTransportation Broker