| Doctor Name: | JENSE BENJAMIN |
| NPI Number: | 1205943263 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D., M.S., FRCS |
| License Number: | L2800 |
| Business Practice Address: | 1611 N Belt Line Rd Suite A Mesquite, TX - 751491722 |
| Business Phone Number: | 9726131000 |
| Business Fax Number: | 9726134232 |
| Mailing Address: | 1611 N Belt Line Rd, Suite A MESQUITE |
| State: | TX |
| Postal Code: | 751491722 |
| Phone Number: | 9726131000 |
| Fax Number: | 9726134232 |
| NPI Enumeration Date: | 08/24/2006 |
| NPI Last Update Date: | 05/22/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | L2800 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |