MEDICARE: BENSTEL HEALTHCARE SERVICES

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	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0015NP	OTHER	TX	BCBS GROUP NUMBER

General Provider Information

NPI Number	:	1447206016
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BENSTEL HEALTHCARE SERVICES

Provider Business Mailing Address
First Line	:	2855 KATE LN
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-8540
Country	:	US
Telephone Number	:	817-277-2127
Fax Number	:	817-277-2157

Provider Business Practice Location Address
First Line	:	623 MATLOCK CENTRE CIR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76015-2535
Country	:	US
Telephone Number	:	817-277-2127
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	STELLA N NWANKWO
Credential	:	M.D.
Telephone Number	:	817-277-2127

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	10/24/2007

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Directions to “BENSTEL HEALTHCARE SERVICES ” Practice Location

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