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1770566259

NPI Code Detail

MEDICARE: DAN TAYLOR BENSCOTER II D.O.

MEDICARE: DAN TAYLOR BENSCOTER II D.O.

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	207ZP0105X	Clinical Pathology/Laboratory Medicine Physician	4304	AZ
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	208A9257	CA
3	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	OS9574	FL
4	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	056529	GA
5	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	36114426	IL
6	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	H63230	MD
7	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	1906	MN
8	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	192182	NY
9	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	4345	OK
10	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	OS005290L	PA
11	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	K9022	TX
12	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	58676861204	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8M8255	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1770566259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAN TAYLOR BENSCOTER II D.O.

Provider Business Mailing Address
First Line	:	1355 RIVER BEND DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75247-4915
Country	:	US
Telephone Number	:	214-638-2000
Fax Number	:	214-237-1864

Provider Business Practice Location Address
First Line	:	713 E ANDERSON ST
Second Line	:
City	:	WEATHERFORD
State	:	TX
Zip	:	76086-5705
Country	:	US
Telephone Number	:	214-638-2000
Fax Number	:	214-237-1864

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

Provider Enumeration Date	:	11/29/2005
Last Update Date	:	02/02/2015

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Directions to “ DAN TAYLOR BENSCOTER II D.O.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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