Benny Illickal, is a
Radiology - Diagnostic Radiology physician based in Sunnyvale, Texas. Benny Illickal is licensed to practice in Texas (license number R37333) and his current practice location is 291 Stone Mountain Dr, Sunnyvale, Texas. He can be reached at his office (for appointments etc.) via phone at
(972) 352-7260.
NPI number for Benny Illickal is 1740682673 and his current mailing address is 291 Stone Mountain Dr, Sunnyvale, Texas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1740682673.
Physician's Profile
Full Name | Benny Illickal |
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Gender | Male |
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Speciality | Radiology - Diagnostic Radiology |
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Location | 291 Stone Mountain Dr, Sunnyvale, Texas |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1740682673
- Provider Enumeration Date: 09/23/2014
- Last Update Date: 09/23/2014
Medical Identifiers
Medical identifiers for Benny Illickal such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1740682673 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2085R0202X | Radiology - Diagnostic Radiology | R37333 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Benny Illickal is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Benny Illickal, 291 Stone Mountain Dr, Sunnyvale, TX 75182-2655 Ph: (972) 352-7260 | Benny Illickal, 291 Stone Mountain Dr, Sunnyvale, TX 75182-2655 Ph: (972) 352-7260 |
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