Ezekiel, Bennett J.

Ezekiel, Bennett J. is an individual health care provider with primary practice located at 1900 Scenic Dr Ste 1108 , Georgetown TX 78626-7724. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is his primary health care specialty. Ezekiel, Bennett J. can be contacted via phone (512) 400-4195.

Contact Information

Primary practice address
1900 Scenic Dr Ste 1108 Georgetown TX 78626-7724
Phone: (512) 400-4195
Fax: (512) 287-5563
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X N6287 Texas
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X N6287 Texas
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X N6287 Texas

Profile Details

NPI number 1477734721
LBN Legal business name Ezekiel, Bennett J.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2007
Last updated Feb 17th, 2020 - about 4 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 1477734721 NPPES
Texas MEDICAID 282030002
Texas MEDICAID 282030003

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