Individual
DR. BRYAN DOUGLAS BENBOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4100 SUMMERHILL RD, TEXARKANA, TX 75503-2732
(903) 735-9802
(903) 735-9806
Mailing address
4100 SUMMERHILL RD, TEXARKANA, TX 75503-2732
(903) 735-9802
(903) 735-9806
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
J8204
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00T11F
BLUE CROSS
TX
05
—
035939001
—
TX
05
—
035939003
—
TX
05
—
100152870A
—
OK
05
—
127728001
—
AR
05
—
1490270
—
LA
01
—
97055
BLUE CROSS
AR
Enumeration date
07/11/2005
Last updated
07/16/2025
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