MRS. JETTA MELINDA BENNER (NPI# 1073581609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073581609 |
| Entity Type | Individual |
| Full Name | MRS. JETTA MELINDA BENNER |
| Credential | PT |
| Practice Address |
638 Uptown Blvd Suite 1105 Cedar Hill TX 75104-3507 |
| Practice Telephone | 4692723129 |
| Practice Fax Number | 4692723145 |
| Mailing Telephone | 4692723129 |
| Mailing Fax Number | 4692723145 |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2014-01-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
1106805 | TX | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS | 8T1319 | 01 |
| Street Address |
638 UPTOWN BLVD SUITE 1105 |
| City | CEDAR HILL |
| State | TX |
| Zip Code | 75104-3507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124571583 | Andrew Aaron Arriaga | Physical Therapist | 638 Uptown Blvd, Ste 110, Cedar Hill, TX 75104-3538 | 2016-08-02 |
| 1316348659 | Crystal Parrish | Physical Therapy Assistant | 638 Uptown Blvd, Suite 110, Cedar Hill, TX 75104-3538 | 2014-09-05 |
| 1316296031 | Andrew Paul Chartrain | Physical Therapist | 638 Uptown Blvd, Suite 110, Cedar Hill, TX 75104-3538 | 2012-09-10 |
| 1497980957 | Smile Care Cedar Hill | Dentist | 638 Uptown Blvd, Suite 100, Cedar Hill, TX 75104-3507 | 2009-05-27 |
| 1306070537 | Ali Bayat | Dentist | 638 Uptown Blvd, Suite 100, Cedar Hill, TX 75104-3538 | 2009-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225647613 | Maurice Leung | Optometrist | 305 W. Fm1382 Bldg 500, Suite 500, Cedar Hill, TX 75104 | 2020-07-30 |
| 1073156055 | Collier Family Dnetistry Pllc | Dentist | 918 E Pleasant Run Rd, Ste 120, Cedar Hill, TX 75104 | 2019-10-23 |
| 1760038061 | Shawn Brandon Fitzpatrick | Optometrist | 500, 305 E Farm To Market Rd., 1382 #500, Cedar Hill, TX 75104 | 2019-08-13 |
| 1487120093 | Daniel Max & Marcandrea, LLC | Optometrist | 401 J Elmer Weaver Fwy, Cedar Hill, TX 75104 | 2018-10-22 |
| 1386153567 | Professional Np Cares Inc | Family Medicine | 1438 Oxbow Dr., Cedar Hill, TX 75104 | 2017-09-20 |
| 1295273688 | Ikids Pediatric Dentistry Cedar Hill, Pllc | Dentist | 520 W. Fm 1382, Cedar Hill, TX 75104 | 2017-02-06 |
| 1598178568 | Meredith Lee Orseth | Dermatology | 610 Uptown Blvd Ste 102, Cedar Hill, TX 75104 | 2014-06-08 |
| 1295160943 | Cedar Hill Medical Center LLC | Clinic/Center | 850 Hwy 67 N, Cedar Hill, TX 75104 | 2013-09-12 |
| 1447699202 | Tammy Audrenia Clay | Registered Nurse | 1336 Boyd Street, Cedar Hill, TX 75104 | 2013-06-14 |
| 1205172020 | Felistar Ogechi Awhen | Licensed Vocational Nurse | 1277 Cedarhill, Cedarhill, TX 75104 | 2012-12-26 |
| Find all providers in zip 75104 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245837889 | Jeremy Tan | Physical Therapist | 505 S Friendswood Dr Ste 101, Friendswood, TX 77546-2254 | 2020-10-06 |
| 1184232100 | Cindy Hon Pt Pllc | Physical Therapist | 3832 Gildas Path, Pflugerville, TX 78660-4168 | 2020-07-15 |
| 1114544095 | Morgan Sanders | Physical Therapist | 2419 Tx 121, Bedford, TX 76021 | 2020-06-26 |
| 1790300226 | Jave Del Rosario | Physical Therapist | 3601 N Macgregor Way Ste 514, Houston, TX 77004-8004 | 2020-06-10 |
| 1922634724 | Carra Dudley | Physical Therapist | 415 E Parkwood Ave, Friendswood, TX 77546-5149 | 2020-03-13 |
| 1013542513 | Alexis Nicole Shoope | Physical Therapist | 3300 Cummins St Apt 2329, Houston, TX 77027-5992 | 2020-03-05 |
| 1861026437 | Robin Elizabeth Mcgee | Physical Therapist | 2555 Gulf Fwy S Ste 400, League City, TX 77573-6742 | 2020-02-23 |
| 1811520612 | Christopher William Chenault X | Physical Therapist | 14857 Southwest Fwy # C303, Sugar Land, TX 77478-5016 | 2020-02-20 |
| 1770116584 | Jordan William Ordoyne | Physical Therapist | 545 Creekside Xing Ste 138, New Braunfels, TX 78130-4271 | 2020-02-20 |
| 1972136851 | Nicole Marie Baker | Physical Therapist | 9180 Pinecroft Dr, Shenandoah, TX 77380-2794 | 2020-02-19 |
| Find all providers with the same taxonomy | ||||
| City | CEDAR HILL |
| Zip Code | 75104 |
Please comment or provide details below to improve the information on MRS. JETTA MELINDA BENNER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.