Provider Demographics
NPI:1770566259
Name:BENSCOTER, DAN TAYLOR II (DO)
Entity type:Individual
Prefix:
First Name:DAN
Middle Name:TAYLOR
Last Name:BENSCOTER
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 RIVER BEND DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-4915
Mailing Address - Country:US
Mailing Address - Phone:214-638-2000
Mailing Address - Fax:214-237-1864
Practice Address - Street 1:713 E ANDERSON ST
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-5705
Practice Address - Country:US
Practice Address - Phone:214-638-2000
Practice Address - Fax:214-237-1864
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4304207ZP0105X
CA208A9257207ZP0102X
FLOS9574207ZP0102X
GA056529207ZP0102X
IL36114426207ZP0102X
MDH63230207ZP0102X
MN1906207ZP0102X
NY192182207ZP0102X
OK4345207ZP0102X
PAOS005290L207ZP0102X
TXK9022207ZP0102X
UT58676861204207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8M8255OtherBCBS
TXD98639Medicare UPIN
TX8D1247Medicare ID - Type Unspecified