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Individual

DR. ERIC S BENNOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6000 BAY PARK CT, FLOWER MOUND, TX 75022-5576
(972) 724-0769
(972) 539-6485
Mailing address
PO BOX 270549, FLOWER MOUND, TX 75027-0549
(972) 724-0769
(972) 539-6485

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G7164
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
122344801
TX
01
MDG7164
GROUP
Enumeration date
07/01/2005
Last updated
04/04/2012
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