Individual
DR. BENTON R. MIDDLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3600 GASTON AVE, WADLEY TOWER, 261, DALLAS, TX 75246-1800
(214) 818-9100
(214) 818-9180
Mailing address
3600 GASTON AVE, BARNETT TOWER, 261, DALLAS, TX 75246-1800
(214) 823-6492
(214) 818-9180
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
0000062995
TN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
J6596
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042637101
—
TX
01
—
83P752
BLUE CROSS BLUE SHEILD
TX
01
—
P00101012
RAILROAD MEDICARE
TX
Enumeration date
06/25/2006
Last updated
03/31/2022
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