Individual
MICHAEL JOHN BENCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1340 WONDER WORLD DR STE 4301, SAN MARCOS, TX 78666-7695
(512) 353-6400
(512) 353-3039
Mailing address
1340 WONDER WORLD DR STE 4301, SAN MARCOS, TX 78666-7695
(512) 353-6400
(512) 353-3039
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
P7245
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1F1019
MEDICARE
TX
01
—
1F9898
MEDICARE LOHP
—
05
—
347209402
—
TX
05
—
347209403
—
TX
01
—
P02531938
MEDICARE RAIL ROAD
TX
01
—
P02539564
RR MEDICARE LOHP
—
Enumeration date
08/30/2006
Last updated
06/02/2021
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