Benardete, Ethan

Benardete, Ethan is an individual health care provider with primary practice located at 2401 S 31St St , Temple TX 76508-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Benardete, Ethan can be contacted via phone (254) 724-2111.

Contact Information

Primary practice address
2401 S 31St St Temple TX 76508-0001
Phone: (254) 724-2111
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 25MA08891900 New Jersey
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X Q6810 Texas

Profile Details

NPI number 1659366987
LBN Legal business name Benardete, Ethan
Credentials MD, PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2005
Last updated Dec 7th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659366987 NPPES
Pennsylvania MEDICAID 102577524
Pennsylvania MEDICAID 0261076
Pennsylvania MEDICAID 02460933

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