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NPI Code Detail

MEDICARE: DR. BENJAMIN CONNER M.D.

MEDICARE: DR. BENJAMIN CONNER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianG9270TX

General Provider Information

NPI Number : 1033170014
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BENJAMIN CONNER M.D.
Provider Business Mailing Address
First Line : 3120 SOUTHWEST FWY
Second Line : SUITE 530
City : HOUSTON
State : TX
Zip : 77098-4509
Country : US
Telephone Number : 713-627-9729
Fax Number :
Provider Business Practice Location Address
First Line : 3120 SOUTHWEST FWY
Second Line : SUITE 530
City : HOUSTON
State : TX
Zip : 77098-4509
Country : US
Telephone Number : 713-627-9729
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2006
Last Update Date : 10/22/2007

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