Provider Demographics
NPI:1477751519
Name:BENSON, JAMES Z (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:Z
Last Name:BENSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 AVENUE F
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77414-3413
Mailing Address - Country:US
Mailing Address - Phone:979-245-1414
Mailing Address - Fax:979-245-1555
Practice Address - Street 1:1221 AVENUE F
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:TX
Practice Address - Zip Code:77414-3413
Practice Address - Country:US
Practice Address - Phone:979-245-1414
Practice Address - Fax:979-245-1555
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4128111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
8AD992OtherBCBS
TX001259301Medicaid
TXTXB130118Medicare PIN
TX001259301Medicaid
TXT12180Medicare UPIN