Individual
AUSTIN FORD BENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1400 8TH AVE, FORT WORTH, TX 76104-4110
(817) 926-2544
Mailing address
1400 8TH AVE, FORT WORTH, TX 76104-4110
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1150379
NCCPA
TX
Enumeration date
01/23/2018
Last updated
05/01/2023
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