Individual
TODD DAVID BENGTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
J5139
TX
2086S0129X
Vascular Surgery Physician
Primary
J5139
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020039690
MEDICARE RAILROAD
TX
01
—
123704
CHIPS
TX
05
—
123916203
—
TX
01
—
5076044
AETNA
TX
01
—
75-2616977-130
TRICARE
TX
01
—
752616977053
TRICARE CHAMPUS
TX
01
—
752616977083
TRICARE
TX
01
—
752616977111
TRICARE
TX
01
—
88860G
BCBS
TX
Enumeration date
02/10/2006
Last updated
10/30/2025
Update your record
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