Todd David Bengtson in Tyler - Vascular Surgery
Todd David Bengtson - NPI 1912970773
Todd David Bengtson is a Vascular Surgery in Tyler, Texas. Todd David Bengtson practices all healthcare services and medical treatments related to Vascular Surgery. The NPI Number for Todd David Bengtson is 1912970773. The last update date is 2017-05-05.
Todd David Bengtson's current location address is 619 S Fleishel Ave, Tyler, Texas. You can contact this provider via phone number 9035251400. The mailing address for Todd David Bengtson is 619 S Fleishel Ave, Tyler, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Todd David Bengtson |
|---|---|
| Address | 619 S Fleishel Ave, Tyler, Texas |
| Phone Number | 9035251400 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1912970773 |
|---|---|
| Provider Enumeration Date | 2006-02-10 |
| Last Updated Date | 2017-05-05 |
Provider Mailing Address Detail
| Address | 619 S Fleishel Ave |
|---|---|
| City | Tyler |
| State | Texas (TX) |
| Post Code | 757012004 |
| Phone Number | 9035251400 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Vascular Surgery |
|---|---|
| Taxonomy | 2086S0129X |
| Licence No | J5139 |
|
Definition: A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 20039690 | TX | MEDICARE RAILROAD | |
| 123704 | TX | CHIPS | |
| 752616977111 | TX | TRICARE | |
| 752616977053 | TX | TRICARE CHAMPUS | |
| 75-2616977-130 | TX | TRICARE | |
| 5076044 | TX | AETNA | |
| 123916203 | TX | -- | |
| 752616977083 | TX | TRICARE | |
| 88860G | TX | BCBS |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Todd David Bengtson by the Centers for Medicare & Medicaid Services?
The Todd David Bengtson has been issued the NPI (National Provider Identifier) 1912970773, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Todd David Bengtson is physically located?
The Todd David Bengtson is physically situated at the following address: 619 S Fleishel Ave, Tyler, TX, 757012004.
What is Todd David Bengtson's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Todd David Bengtson's specialized field of practice is Vascular Surgery, and the corresponding taxonomy code that categorizes this area of specialization is 2086S0129X.
On what date did the Todd David Bengtson receive its 1912970773 assignment from the Centers for Medicare & Medicaid Services?
The Todd David Bengtson was assigned its 1912970773 by the Centers for Medicare & Medicaid Services on 2006-02-10.
When was the information related to Todd David Bengtson most recently updated or refreshed?
The details pertaining to the Todd David Bengtson, including its address, specialty, and other relevant information, were last updated or refreshed on 2017-05-05.