Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | N5629 | TX |
N | 207YS0123X | Facial Plastic Surgeon | N5629 | TX |
NPI | 1376525527 |
---|---|
Provider Name | Dr. Benjamin West Cilento |
First Address | Spring, TX 77388-3427 |
Second Address | Spring, TX 77388-3427 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2005 |
Last Update Date | 21/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
TXB102309 | MEDICARE PTAN (01) | TX |
TXB107759 | MEDICARE PTAN (01) | TX |
TXB107760 | MEDICARE PTAN (01) | TX |