Healthcare Provider Details

I. General information

NPI: 1205510641
Provider Name (Legal Business Name): BENJAMIN ESCHLER PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 HOLCOMBE BLVD UNIT 431
HOUSTON TX
77030-4000
US

IV. Provider business mailing address

7950 N STADIUM DR APT 231
HOUSTON TX
77030-4414
US

V. Phone/Fax

Practice location:
  • Phone: 713-792-5469
  • Fax:
Mailing address:
  • Phone: 801-430-8515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: