Individual
DR. BENJAMIN HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1504 W LEAGUE CITY PKWY, SUITE 100, LEAGUE CITY, TX 77573-7077
(409) 467-6209
Mailing address
1504 W LEAGUE CITY PKWY, SUITE 100, LEAGUE CITY, TX 77573-7077
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
13309
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
570994ZY3S
MEDICARE
TX
Enumeration date
10/04/2016
Last updated
06/06/2017
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