Individual
TODD DAVID BENGTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
619 S FLEISHEL AVE, STE 203, TYLER, TX 75701-2004
(903) 525-1400
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6450
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
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us