| Dr Ben Deheshi Orthopedics Pllc | |
|
1545 E Southlake Blvd Southlake TX 76092-6422 | |
| (817) 322-7867 | |
| (817) 322-7861 |
| Full Name | Dr Ben Deheshi Orthopedics Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1545 E Southlake Blvd, Southlake, Texas |
| Authorized Official Name and Position | Ben Deheshi (OWNER) |
| Authorized Official Contact | 8178073511 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Ben Deheshi Orthopedics Pllc 1545 E Southlake Blvd Southlake TX 76092-6422 Ph: (817) 322-7867 | Dr Ben Deheshi Orthopedics Pllc 1545 E Southlake Blvd Southlake TX 76092-6422 Ph: (817) 322-7867 |
| NPI Number | 1992263628 |
|---|---|
| Provider Enumeration Date | 03/12/2019 |
| Last Update Date | 09/05/2024 |
| Medicare PECOS PAC ID | 1759623713 |
|---|---|
| Medicare Enrollment ID | O20190424000329 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992263628 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Benjamin Michael Deheshi |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1447774997 PECOS PAC ID: 8022383215 Enrollment ID: I20171016000490 |
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