MEDICARE: DR. WILLIAM HENRY BENEFIELD JR. PHARMD, BCPP

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	1835P1300X	Psychiatric Pharmacist	31688	TX

General Provider Information

NPI Number	:	1609873694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM HENRY BENEFIELD JR. PHARMD, BCPP

Provider Business Mailing Address
First Line	:	4502 MEREDITH WOODS ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-1410
Country	:	US
Telephone Number	:	210-408-0385
Fax Number	:	210-408-0386

Provider Business Practice Location Address
First Line	:	4502 MEREDITH WOODS ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-1410
Country	:	US
Telephone Number	:	210-408-0385
Fax Number	:	210-408-0386

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

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	07/08/2007

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