Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 11658 | TX |
N | 111NI0013X | Independent Medical Examiner | 11658 | TX |
N | 111NN0400X | Neurology | 11658 | TX |
N | 111NN1001X | Nutrition | 11658 | TX |
N | 111NP0017X | Pediatric Chiropractor | 11658 | TX |
N | 111NR0200X | Radiology | 11658 | TX |
N | 213ER0200X | Radiology | 11658 | TX |
N | 111NR0400X | Rehabilitation Chiropractor | 11658 | TX |
N | 111NS0005X | Chiropractic Sports Physician | 11658 | TX |
N | 111NX0100X | Occupational Health | 11658 | TX |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 11658 | TX |
NPI | 1487953345 |
---|---|
Provider Name | Dr. Benjamin M Meshack |
First Address | Houston, TX 77031-3602 |
Second Address | Houston, TX 77031-3602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2011 |
Last Update Date | 07/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11658 | TEXAS BOARD OF CHIROPRACTIC EXAMINERS (01) | TX |