Provider Demographics
NPI:1285797126
Name:DISABILITY EVALUATING CENTER OF TEXAS, INC
Entity type:Organization
Organization Name:DISABILITY EVALUATING CENTER OF TEXAS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:361-857-6157
Mailing Address - Street 1:601 TEXAN TRL
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-2547
Mailing Address - Country:US
Mailing Address - Phone:361-857-6157
Mailing Address - Fax:361-857-6974
Practice Address - Street 1:601 TEXAN TRL
Practice Address - Street 2:SUITE 201
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-2547
Practice Address - Country:US
Practice Address - Phone:361-857-6157
Practice Address - Fax:361-857-6974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE2253207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty