Provider Demographics
NPI:1588950646
Name:BENJAMIN MINTER
Entity type:Organization
Organization Name:BENJAMIN MINTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:MINTER
Authorized Official - Suffix:
Authorized Official - Credentials:RPSGT
Authorized Official - Phone:281-213-3087
Mailing Address - Street 1:24303 ROCKIN SEVEN DR
Mailing Address - Street 2:
Mailing Address - City:HOCKLEY
Mailing Address - State:TX
Mailing Address - Zip Code:77447-9295
Mailing Address - Country:US
Mailing Address - Phone:281-213-3087
Mailing Address - Fax:281-398-3932
Practice Address - Street 1:16126 SOUTHWEST FWY
Practice Address - Street 2:#230
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2638
Practice Address - Country:US
Practice Address - Phone:281-213-3087
Practice Address - Fax:281-398-3932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic