Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | M8635 | TX |
Y | 2086S0105X | Surgery of the Hand | M8635 | TX |
NPI | 1942274899 |
---|---|
Provider Name | Benjamin Todd Drury |
First Address | Bedford, TX 76021-5011 |
Second Address | Bedford, TX 76021-5011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2006 |
Last Update Date | 15/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
357737101 | (05) | TX |
H18615 | (02) |