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Individual

ANSLEY BENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
12200 PARK CENTRAL DR STE 400, DALLAS, TX 75251-2116
(214) 483-9300
Mailing address
450 W MEDICAL CENTER BLVD, #600-C, WEBSTER, TX 77598-4234
(281) 554-1690
(281) 316-0590

Taxonomy

Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
PA08269
TX
363A00000X
Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1235478645
TX
Enumeration date
02/05/2013
Last updated
02/04/2020
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