Individual
BUSH CHACKO BENJAMIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MBA
Contact information
Practice address
2840 LEGACY DR STE 400, FRISCO, TX 75034-6055
(469) 200-6100
Mailing address
2840 LEGACY DR STE 400, FRISCO, TX 75034-6055
(469) 200-6100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
T0056
TX
Other
Enumeration date
04/09/2018
Last updated
09/08/2021
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