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NPI Code Detail

MEDICARE: BEN JACOB HERSH MD

MEDICARE: BEN JACOB HERSH MD
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
1207Q00000XFamily Medicine PhysicianMD180677OR
2207Q00000XFamily Medicine PhysicianME140566FL
3390200000XStudent in an Organized Health Care Education/Training Program
4207Q00000XFamily Medicine PhysicianU9953TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346636065
Entity Type Code : Individual
Provider Name (Legal Business Name) : BEN JACOB HERSH MD
Provider Business Mailing Address
First Line : 825 E RUNDBERG LN STE B1
Second Line :
City : AUSTIN
State : TX
Zip : 78753-4860
Country : US
Telephone Number : 512-978-9600
Fax Number : 512-901-9771
Provider Business Practice Location Address
First Line : 825 E RUNDBERG LN STE B1
Second Line :
City : AUSTIN
State : TX
Zip : 78753-4860
Country : US
Telephone Number : 512-978-9600
Fax Number : 512-901-9771
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2015
Last Update Date : 09/06/2024

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Directions to “ BEN JACOB HERSH MD” Practice Location

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