Provider Demographics
NPI:1508998576
Name:SMITH, BENJAMIN H (MD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:H
Last Name:SMITH
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 1:8815 DYER ST STE 130
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79904-2037
Mailing Address - Country:US
Mailing Address - Phone:210-290-4314
Mailing Address - Fax:
Practice Address - Street 1:8815 DYER ST STE 130
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79904-2037
Practice Address - Country:US
Practice Address - Phone:915-757-3937
Practice Address - Fax:915-757-3946
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS4690207W00000X
UT6207901-1205207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology