Provider Demographics
NPI:1285710053
Name:BENING, THOMAS G (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:G
Last Name:BENING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 JOHN W HOOVER PKWY BLDG III
Mailing Address - Street 2:
Mailing Address - City:BURNET
Mailing Address - State:TX
Mailing Address - Zip Code:78611-4560
Mailing Address - Country:US
Mailing Address - Phone:512-715-3046
Mailing Address - Fax:512-715-3048
Practice Address - Street 1:1205 CENTRAL TEXAS EXPY
Practice Address - Street 2:
Practice Address - City:LAMPASAS
Practice Address - State:TX
Practice Address - Zip Code:76550-3388
Practice Address - Country:US
Practice Address - Phone:512-556-5362
Practice Address - Fax:512-556-8004
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5049207P00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX184348406Medicaid
TX184348405Medicaid
TX8L1225Medicare PIN
TX184348405Medicaid
TXP00975694Medicare PIN