Provider Demographics
NPI:1952021230
Name:BISHOP, BENJAMIN ANDREW (DC)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:ANDREW
Last Name:BISHOP
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:8800 US HIGHWAY 380 STE 800
Mailing Address - Street 2:
Mailing Address - City:CROSSROADS
Mailing Address - State:TX
Mailing Address - Zip Code:76227-2516
Mailing Address - Country:US
Mailing Address - Phone:940-440-1211
Mailing Address - Fax:940-440-1212
Practice Address - Street 1:3505 OCEANVIEW DR
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76208-6057
Practice Address - Country:US
Practice Address - Phone:469-684-1821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17523111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Multi-Specialty