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General NPI Number Information
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NPI Number | 1790071215
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Entity Type | Individual
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Provider Name | BENJAMIN JOSEPH SEIDEL D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/23/2011
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Last Update Date | 10/09/2023
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Provider Practice Location Address
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Address Line | 7400 MERTON MINTER ST
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City | SAN ANTONIO
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State | TX
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Zip | 78229-4404
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Country | US
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Telephone | 210-617-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 226 NEWELL AVE APT 116
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City | SAN ANTONIO
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State | TX
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Zip | 78215-1611
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Country | US
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Telephone | 914-882-0027
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Fax |
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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 | 2081P0301X
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Taxonomy Name | Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 295272
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License Number State | NY
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