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General NPI Number Information
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NPI Number | 1174016539
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Entity Type | Individual
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Provider Name | EMILY BENGSTON PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/11/2018
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 3006 N COUNTY ROAD 25A STE 104
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City | TROY
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State | OH
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Zip | 45373-1373
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Country | US
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Telephone | 937-335-3518
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Fax | 937-332-6857
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Provider Business Mailing Address
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Address Line | 3600 FM 2181 STE 100
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City | HICKORY CREEK
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State | TX
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Zip | 75065-7636
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Country | US
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Telephone | 940-498-4422
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Fax | 940-321-1045
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | TX
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