Bengtson, Todd David
Bengtson, Todd David is an individual health care provider with primary practice located at 619 S Fleishel Ave Ste 203, Tyler TX 75701-2004. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Bengtson, Todd David can be contacted via phone (903) 525-1400.Contact Information
Primary practice address
619 S Fleishel Ave Ste 203
Tyler TX 75701-2004
Phone: (903) 525-1400
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | J5139 | Texas |
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | J5139 | Texas |
Profile Details
| NPI number | 1912970773 |
|---|---|
| LBN Legal business name | Bengtson, Todd David |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 10th, 2006 |
| Last updated | Oct 30th, 2025 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912970773 | NPPES |
| Texas | Other | 020039690 | MEDICARE RAILROAD |
| Texas | Other | 123704 | MEDICARE RAILROAD |
| Texas | Other | 752616977111 | MEDICARE RAILROAD |
| Texas | Other | 752616977053 | MEDICARE RAILROAD |
| Texas | Other | 75-2616977-130 | MEDICARE RAILROAD |
| Texas | Other | 5076044 | MEDICARE RAILROAD |
| Texas | MEDICAID | 123916203 | MEDICARE RAILROAD |
| Texas | Other | 752616977083 | MEDICARE RAILROAD |
| Texas | Other | 88860G | MEDICARE RAILROAD |
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