Provider Demographics
NPI:1023683737
Name:BENJAMIN, BARRY (DC)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:
Last Name:BENJAMIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:BARRY
Other - Middle Name:
Other - Last Name:AKHIGBE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:45 REGENTS PARK
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-6557
Mailing Address - Country:US
Mailing Address - Phone:214-580-6752
Mailing Address - Fax:
Practice Address - Street 1:45 REGENTS PARK
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6557
Practice Address - Country:US
Practice Address - Phone:214-580-6752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14767111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor