MEDICARE: DR. BENJAMIN M MESHACK DC

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	111N00000X	Chiropractor	11658	TX
2	111NI0013X	Independent Medical Examiner Chiropractor	11658	TX
3	111NN0400X	Neurology Chiropractor	11658	TX
4	111NN1001X	Nutrition Chiropractor	11658	TX
5	111NP0017X	Pediatric Chiropractor	11658	TX
6	111NR0200X	Radiology Chiropractor	11658	TX
7	111NR0400X	Rehabilitation Chiropractor	11658	TX
8	111NS0005X	Sports Physician Chiropractor	11658	TX
9	111NX0100X	Occupational Health Chiropractor	11658	TX
10	111NX0800X	Orthopedic Chiropractor	11658	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11658	OTHER	TX	TEXAS BOARD OF CHIROPRACTIC EXAMINERS

General Provider Information

NPI Number	:	1487953345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENJAMIN M MESHACK DC

Provider Business Mailing Address
First Line	:	11100 SOUTHWEST FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77031-3602
Country	:	US
Telephone Number	:	713-771-2225
Fax Number	:	713-771-1876

Provider Business Practice Location Address
First Line	:	11100 SOUTHWEST FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77031-3602
Country	:	US
Telephone Number	:	713-771-2225
Fax Number	:	713-771-1876

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

Provider Enumeration Date	:	03/17/2011
Last Update Date	:	01/07/2016

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