Individual
DR. ELIE BENAIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7777 FOREST LN, A230, DALLAS, TX 75230-2505
(972) 566-7765
(972) 566-4656
Mailing address
3600 GASTON AVE, SUITE 1205, DALLAS, TX 75246-1800
(214) 692-8262
(214) 696-4190
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
19631
OK
208800000X
Urology Physician
Primary
L4242
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152766503
—
TX
05
—
152766504
—
TX
01
—
80424X
BCBS
TX
01
—
P00360206
RR MEDICARE
TX
Enumeration date
04/07/2006
Last updated
01/31/2017
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