Bengtson, Todd David

Bengtson, Todd David is an individual health care provider with primary practice located at 619 S Fleishel Ave Ste 203, Tyler TX 75701-2004. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Bengtson, Todd David can be contacted via phone (903) 525-1400.

Contact Information

Primary practice address
619 S Fleishel Ave Ste 203 Tyler TX 75701-2004
Phone: (903) 525-1400
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X J5139 Texas
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X J5139 Texas

Profile Details

NPI number 1912970773
LBN Legal business name Bengtson, Todd David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 10th, 2006
Last updated May 5th, 2017 - about 7 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 1912970773 NPPES
Texas Other 020039690 MEDICARE RAILROAD
Texas Other 123704 MEDICARE RAILROAD
Texas Other 752616977111 MEDICARE RAILROAD
Texas Other 752616977053 MEDICARE RAILROAD
Texas Other 75-2616977-130 MEDICARE RAILROAD
Texas Other 5076044 MEDICARE RAILROAD
Texas MEDICAID 123916203 MEDICARE RAILROAD
Texas Other 752616977083 MEDICARE RAILROAD
Texas Other 88860G MEDICARE RAILROAD

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