Provider Demographics
NPI:1447295316
Name:BENZICK, JEFFREY M (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:M
Last Name:BENZICK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12915 JONES MALTSBERGER RD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-4282
Mailing Address - Country:US
Mailing Address - Phone:210-403-2050
Mailing Address - Fax:210-403-9890
Practice Address - Street 1:12915 JONES MALTSBERGER RD
Practice Address - Street 2:STE 600
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-4282
Practice Address - Country:US
Practice Address - Phone:210-403-2050
Practice Address - Fax:210-403-9890
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2007-07-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXL76652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry