Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | S2234 | TX |
NPI | 1003264375 |
---|---|
Provider Name | Adam Clemens Benzing |
First Address | San Antonio, TX 78229-4402 |
Second Address | San Antonio, TX 78229-4402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2016 |
Last Update Date | 12/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
399187901 | (05) | TX |