Organization
IMED INTERNAL MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VERNON ROGER BENSON M.D.F.A.C.P. (PRESIDENT)
(210) 404-0000
Entity
Organization
Contact information
Practice address
255 E SONTERRA BLVD, SUITE 100, SAN ANTONIO, TX 78258-3990
(210) 404-0000
(210) 581-0120
Mailing address
PO BOX 867, SAN ANTONIO, TX 78293-0867
(210) 404-0000
(210) 581-0120
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0051EB
BLUE CROSS IDENTIFIER
TX
Enumeration date
12/06/2005
Last updated
08/22/2020
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