MEDICARE: BENGAL HEALTH CENTER PLLC

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	207R00000X	Internal Medicine Physician	D5478	TX

General Provider Information

NPI Number	:	1639579535
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BENGAL HEALTH CENTER PLLC

Provider Business Mailing Address
First Line	:	6430 HILLCROFT ST
Second Line	:	SUITE 100A
City	:	HOUSTON
State	:	TX
Zip	:	77081-3191
Country	:	US
Telephone Number	:	713-679-0003
Fax Number	:	832-218-2300

Provider Business Practice Location Address
First Line	:	6430 HILLCROFT ST
Second Line	:	SUITE 100A
City	:	HOUSTON
State	:	TX
Zip	:	77081-3191
Country	:	US
Telephone Number	:	713-679-0003
Fax Number	:	832-218-2300

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. HENRY B. SPANGLER
Credential	:	M.D.
Telephone Number	:	713-679-0003

Provider Enumeration Date	:	08/27/2014
Last Update Date	:	08/27/2014

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