Provider Demographics
NPI:1992700215
Name:MORGAN, BENJAMIN TODD (PT)
Entity type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:TODD
Last Name:MORGAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17325 BELL NORTH DR
Mailing Address - Street 2:SUITE 2-B
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-3368
Mailing Address - Country:US
Mailing Address - Phone:888-590-4002
Mailing Address - Fax:210-590-4585
Practice Address - Street 1:10526 W PARMER LN
Practice Address - Street 2:SUITE 403
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78717-5056
Practice Address - Country:US
Practice Address - Phone:512-900-3302
Practice Address - Fax:512-900-3321
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPT1157667225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149237100OtherFIRSTCARE
TXP00804349OtherMEDICARE RAILROAD
TX8T4146OtherBLUE CROSS BLUE SHIELD
TX220241801Medicaid
TX8D5688Medicare PIN
TX220241802Medicaid