Individual provider · NPI-1

Todd David Bengtson, MD

· Tyler, TX

NPI number1912970773
StatusActive
Last updated in NPPESOct 30, 2025

Details

NPI
1912970773
Entity type
Individual (NPI-1)
Name
Todd David Bengtson
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Feb 10, 2006
Certification date
Oct 30, 2025
Last updated
Oct 30, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2086S0129X J5139TXYes
208600000X SurgeryJ5139TX

Practice location

619 S Fleishel Ave
Ste 203
Tyler, TX 75701-2004

Phone 903-525-1400

Mailing address

Po Box 846098
Dallas, TX 75284-6098

Phone 903-324-6450

Other practice locations

619 S Fleishel Ave Ste 327
Tyler, TX 75701-2019

Phone 903-606-1400

115 Airport Rd
Sulphur Springs, TX 75482-2105

Phone 903-885-7671

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