Individual
KEVIN BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3001 JBS PKWY, ODESSA, TX 79762-8126
(432) 640-6772
(432) 640-4708
Mailing address
PO BOX 2129, ODESSA, TX 79760-2129
(432) 640-6600
(432) 640-4791
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
Q5759
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132606108601
—
TX
Enumeration date
07/25/2006
Last updated
07/21/2022
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