MEDICARE: MICHAEL E BENSON P.T.

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	225100000X	Physical Therapist	1150786	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8T7710	OTHER	TX	BCBS
3	9312107	OTHER		AETNA

General Provider Information

NPI Number	:	1811017692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL E BENSON P.T.

Provider Business Mailing Address
First Line	:	2210 NW MILITARY HWY
Second Line	:	SUITE 101
City	:	SAN ANTONIO
State	:	TX
Zip	:	78213-1815
Country	:	US
Telephone Number	:	210-308-5558
Fax Number	:	210-308-5557

Provider Business Practice Location Address
First Line	:	2210 NW MILITARY HWY
Second Line	:	SUITE 101
City	:	SAN ANTONIO
State	:	TX
Zip	:	78213-1815
Country	:	US
Telephone Number	:	210-308-5558
Fax Number	:	210-308-5557

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

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	06/03/2008

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Directions to “ MICHAEL E BENSON P.T.” Practice Location

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