MEDICARE: HAROLD Z BENCOWITZ 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
1	207RP1001X	Pulmonary Disease Physician	R1810	TX

Other Identifiers

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

General Provider Information

NPI Number	:	1629063912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAROLD Z BENCOWITZ MD

Provider Business Mailing Address
First Line	:	3030 NORTH ST
Second Line	:	SUITE 510
City	:	BEAUMONT
State	:	TX
Zip	:	77702-1433
Country	:	US
Telephone Number	:	409-896-5000
Fax Number	:	409-896-5926

Provider Business Practice Location Address
First Line	:	3030 NORTH ST
Second Line	:	SUITE 510
City	:	BEAUMONT
State	:	TX
Zip	:	77702-1433
Country	:	US
Telephone Number	:	409-896-5000
Fax Number	:	409-896-5926

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

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	02/09/2010

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