MEDICARE: BEN VICTORIA, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician

General Provider Information

NPI Number	:	1265487821
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEN VICTORIA, PA

Provider Business Mailing Address
First Line	:	PO BOX 3856
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77253-3856
Country	:	US
Telephone Number	:	713-622-1700
Fax Number	:

Provider Business Practice Location Address
First Line	:	6242 N NAVARRO ST
Second Line	:
City	:	VICTORIA
State	:	TX
Zip	:	77904-1705
Country	:	US
Telephone Number	:	361-575-4524
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	MR. ELIAS BENHAMOU
Credential	:	MD
Telephone Number	:	713-622-1700

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	10/23/2007

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Directions to “BEN VICTORIA, PA ” Practice Location

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