MEDICARE: KENYON R. BEHRENS, D.O. , P.A

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	207Q00000X	Family Medicine Physician	G7994	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	DN3507	OTHER	TX	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0067RF	OTHER	TX	BLUE CROSS AND BLUE SHIELD OF TEXAS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831363928
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENYON R. BEHRENS, D.O. , P.A

Provider Business Mailing Address
First Line	:	7812 GATEWAY BLVD E
Second Line	:	SUITE 230
City	:	EL PASO
State	:	TX
Zip	:	79915-1803
Country	:	US
Telephone Number	:	915-592-8223
Fax Number	:	915-592-8328

Provider Business Practice Location Address
First Line	:	7812 GATEWAY BLVD E
Second Line	:	SUITE 230
City	:	EL PASO
State	:	TX
Zip	:	79915-1837
Country	:	US
Telephone Number	:	915-592-8223
Fax Number	:	915-592-8328

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. KENYON R. BEHRENS
Credential	:	D.O.
Telephone Number	:	915-592-8223

Provider Enumeration Date	:	04/18/2008
Last Update Date	:	12/30/2011

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Directions to “KENYON R. BEHRENS, D.O. , P.A ” Practice Location

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