Organization
LIGHTHOUSE PHYSICIAN SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESLY BENODIN M.D. (RADIOLOGIST)
(603) 252-7447
Entity
Organization
Contact information
Practice address
427 TRACE WAY DR, MONTGOMERY, TX 77316-6852
(936) 463-8777
(603) 658-0484
Mailing address
427 TRACE WAY DR, MONTGOMERY, TX 77316-6852
(936) 463-8777
(603) 658-0484
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
N9353
TX
Other
Enumeration date
09/20/2011
Last updated
09/20/2011
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