Provider Demographics
NPI:1104966613
Name:BENNING, JAMES DAVID (OD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DAVID
Last Name:BENNING
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:5408 CREEK ARBOR CT
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-7504
Mailing Address - Country:US
Mailing Address - Phone:972-231-3622
Mailing Address - Fax:972-238-8302
Practice Address - Street 1:1384 E BELT LINE RD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-3709
Practice Address - Country:US
Practice Address - Phone:972-231-3622
Practice Address - Fax:972-238-8302
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX3265152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist