MEDICARE: DR. BENJAMIN LAWRENCE ELSBERND M.D.

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	207RG0100X	Gastroenterology Physician	R2092	TX

General Provider Information

NPI Number	:	1487073748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENJAMIN LAWRENCE ELSBERND M.D.

Provider Business Mailing Address
First Line	:	221 W. COLORADO BLVD.
Second Line	:	PAVILION II SUITE 630
City	:	DALLAS
State	:	TX
Zip	:	75208
Country	:	US
Telephone Number	:	469-695-2035
Fax Number	:	469-695-2036

Provider Business Practice Location Address
First Line	:	221 W. COLORADO BLVD.
Second Line	:	PAVILION II SUITE 630
City	:	DALLAS
State	:	TX
Zip	:	75208
Country	:	US
Telephone Number	:	469-695-2035
Fax Number	:	469-695-2036

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2014
Last Update Date	:	05/19/2026

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