Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | P3940 | TX |
NPI | 1083859581 |
---|---|
Provider Name | Dr. Charles Benjamin Newman |
First Address | Dallas, TX 75203-1259 |
Second Address | Dallas, TX 75203-1259 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2008 |
Last Update Date | 07/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
303825901 | (05) | TX |
303825902 | (05) | TX |
8DK220 | BLUE CROSS (01) | TX |