Provider Demographics
NPI:1275363749
Name:BENSON, ANGELA (SURGICAL FIRST ASSIS)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:BENSON
Suffix:
Gender:F
Credentials:SURGICAL FIRST ASSIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 WILTON DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75401-2249
Mailing Address - Country:US
Mailing Address - Phone:469-667-2911
Mailing Address - Fax:
Practice Address - Street 1:333 WILTON DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-2249
Practice Address - Country:US
Practice Address - Phone:469-667-2911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120786208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery