Provider Demographics
NPI:1750392734
Name:BENIGAR JR, ROBERT W (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:W
Last Name:BENIGAR JR
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 1:6839 COMMUNICATIONS PKWY
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-5991
Mailing Address - Country:US
Mailing Address - Phone:469-379-8222
Mailing Address - Fax:
Practice Address - Street 1:6839 COMMUNICATIONS PKWY
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-5991
Practice Address - Country:US
Practice Address - Phone:972-733-7242
Practice Address - Fax:972-733-7257
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM15082084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX612190OtherMEDICARE PTAN
TXI48698Medicare UPIN