Healthcare Provider Details

I. General information

NPI: 1982900452
Provider Name (Legal Business Name): BENJAMIN PAUL MINTER I RPSGT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24303 ROCKIN SEVEN DR
HOCKLEY TX
77447-9295
US

IV. Provider business mailing address

24303 ROCKIN SEVEN DR
HOCKLEY TX
77447-9295
US

V. Phone/Fax

Practice location:
  • Phone: 281-213-3087
  • Fax: 281-398-3932
Mailing address:
  • Phone: 281-213-3087
  • Fax: 281-398-3932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: