Provider Demographics
NPI:1598762205
Name:STEVENS, BENJAMIN JAMES (DO)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:JAMES
Last Name:STEVENS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2728 LOOP 337
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-8504
Mailing Address - Country:US
Mailing Address - Phone:830-609-0080
Mailing Address - Fax:830-629-0416
Practice Address - Street 1:2728 LOOP 337
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-8504
Practice Address - Country:US
Practice Address - Phone:830-609-0080
Practice Address - Fax:830-629-0416
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXB000207Q00000X
TXM1371207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3164402-01OtherWELLMED MEDICAID
TXTXB126391OtherWELLMED MEDICARE
TX3164402-01OtherWELLMED MEDICAID