Provider Demographics
NPI:1578821815
Name:BENJAMIN, SHRUTI BIJAS (MD)
Entity Type:Individual
Prefix:
First Name:SHRUTI
Middle Name:BIJAS
Last Name:BENJAMIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2840 LEGACY DR STE 400
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6055
Mailing Address - Country:US
Mailing Address - Phone:806-470-7918
Mailing Address - Fax:
Practice Address - Street 1:2840 LEGACY DR STE 400
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6055
Practice Address - Country:US
Practice Address - Phone:469-476-5623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-24
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ7839207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology