Provider Demographics
NPI:1700804275
Name:CLAPP, BENJAMIN LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:LEE
Last Name:CLAPP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1700 N MESA ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-3504
Mailing Address - Country:US
Mailing Address - Phone:713-864-3190
Mailing Address - Fax:915-351-6048
Practice Address - Street 1:1700 N MESA ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3504
Practice Address - Country:US
Practice Address - Phone:713-864-3190
Practice Address - Fax:915-351-6048
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35236208600000X
TXM1593208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175811202Medicaid