Basic Information
Provider Information
NPI: 1992700215
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORGAN
FirstName: BENJAMIN
MiddleName: TODD
NamePrefix: MR.
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 17325 BELL NORTH DR
Address2: SUITE 2-B
City: SCHERTZ
State: TX
PostalCode: 781543368
CountryCode: US
TelephoneNumber: 8885904002
FaxNumber: 2105904585
Practice Location
Address1: 10526 W PARMER LN
Address2: SUITE 403
City: AUSTIN
State: TX
PostalCode: 787175056
CountryCode: US
TelephoneNumber: 5129003302
FaxNumber: 5129003321
Other Information
ProviderEnumerationDate: 06/14/2005
LastUpdateDate: 09/27/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT1157667TXY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


Home