Provider Demographics
NPI:1003264375
Name:BENZING, ADAM CLEMENS (MD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:CLEMENS
Last Name:BENZING
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 1:15103 MORNING TREE ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-4613
Mailing Address - Country:US
Mailing Address - Phone:207-710-4750
Mailing Address - Fax:
Practice Address - Street 1:7719 S I-35 FRONTAGE ROAD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232
Practice Address - Country:US
Practice Address - Phone:210-572-2955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-27
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH25658207P00000X
TXS2234207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH25658OtherSTATE MEDICAL LICENSE
TX399187901Medicaid
TXS2234OtherSTATE MEDICAL LICENSE