MEDICARE: BENJAMIN ANDREWS 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	114814	AL
2	111NS0005X	Sports Physician Chiropractor	4351	OK
3	111NS0005X	Sports Physician Chiropractor	15520	TX

General Provider Information

NPI Number	:	1619428166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENJAMIN ANDREWS DC

Provider Business Mailing Address
First Line	:	9904 WINDING RIDGE DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75238-1460
Country	:	US
Telephone Number	:	907-538-7649
Fax Number	:

Provider Business Practice Location Address
First Line	:	3248 NW GRAND BLVD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73116-3019
Country	:	US
Telephone Number	:	907-538-7649
Fax Number	:

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

Provider Enumeration Date	:	10/19/2016
Last Update Date	:	01/07/2025

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Directions to “ BENJAMIN ANDREWS DC” Practice Location

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