MEDICARE: DR. BENJAMIN WEST CILENTO 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
1	207YS0123X	Facial Plastic Surgery Physician	N5629	TX
2	207Y00000X	Otolaryngology Physician	N5629	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	TXB102309	OTHER	TX	MEDICARE PTAN
2	TXB107759	OTHER	TX	MEDICARE PTAN
3	TXB107760	OTHER	TX	MEDICARE PTAN

General Provider Information

NPI Number	:	1376525527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENJAMIN WEST CILENTO M.D.

Provider Business Mailing Address
First Line	:	2940 FM 2920 RD
Second Line	:	SUITE 100
City	:	SPRING
State	:	TX
Zip	:	77388-3427
Country	:	US
Telephone Number	:	346-413-9313
Fax Number	:	281-901-5334

Provider Business Practice Location Address
First Line	:	2940 FM 2920 RD
Second Line	:	SUITE 100
City	:	SPRING
State	:	TX
Zip	:	77388-3427
Country	:	US
Telephone Number	:	346-413-9313
Fax Number	:	281-901-5334

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2005
Last Update Date	:	05/21/2020

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Directions to “ DR. BENJAMIN WEST CILENTO M.D.” Practice Location

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