Basic Information
| Provider Information | |||||||||
| NPI: | 1992128425 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ROBERT W BENIGAR JR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16901 DALLAS PKWY | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | ADDISON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750015226 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 16901 DALLAS PKWY | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | ADDISON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750015226 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143695522 | ||||||||
| FaxNumber: | 2145369532 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/04/2014 | ||||||||
| LastUpdateDate: | 10/31/2016 | ||||||||
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| AuthorizedOfficialLastName: | NELSON | ||||||||
| AuthorizedOfficialFirstName: | SARA | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRACTICE ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 2143695522 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | M1508 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.