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General NPI Number Information
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NPI Number | 1760660914
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Entity Type | Organization
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Legal Business Name | BENCO HEALTHCARE CORPORATION
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Dates
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Enumeration Date | 02/08/2008
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Last Update Date | 02/08/2008
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Provider Practice Location Address
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Address Line | 2646 S LOOP W 425
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City | HOUSTON
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State | TX
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Zip | 77054-2665
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Country | US
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Telephone | 713-592-0192
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Fax | 713-839-9700
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Provider Business Mailing Address
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Address Line | 2646 S LOOP W 425
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City | HOUSTON
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State | TX
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Zip | 77054-2665
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Country | US
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Telephone | 713-592-0192
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Fax | 713-839-9700
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BENSON EZUMA OKORONKWO
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Credential |
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Telephone | 713-592-0192
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 0101011
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License Number State | TX
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