Kevin L Benham, 10665TG OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

10665TG Issued in TX

Practice address

4321 State Highway 6
College Station, TX 77845

Phone

(979) 321-6565

Fax

(979) 321-6566

NPI assigned

Jan 6, 2010

Last updated

Jul 29, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 7

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Killeen Eye Associates, P.a.

  dba First Eye Care Killeen

  • Optometrist
  • Killeen, TX
  • NPI 1457594129
  Medicare reassignment NPD
• Salado Eye Associates PA

  dba VIEW Salado

  • Optometrist
  • Salado, TX
  • NPI 1558898213
  Medicare reassignment NPD
• College Station Vision Center PLLC

  • Optometrist
  • College Station, TX
  • NPI 1487380457
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1262736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1336479724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4321 STATE HIGHWAY 6",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "77845",
            "telephone_number": "979-321-6565",
            "fax_number": "979-321-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4321 STATE HIGHWAY 6",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "77845",
            "telephone_number": "979-321-6565",
            "fax_number": "979-321-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENHAM",
        "first_name": "KEVIN",
        "middle_name": "L",
        "credential": "10665TG OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-06",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7932TG",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TX",
            "license": "7392TG",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "TX",
            "license": "7392TG",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "TX",
            "license": "7392TG",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "TX",
            "license": "7392TG",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "TX",
            "license": "7392TG",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10665TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlin K Beettner
• Elizabeth Begley, CCC-SLP
• Belinda Shae Dobson
• Karen Sue Belter, PH.D.
• Hannah Elizabeth Benavides
• Vivian Benjamin, RBT
• Lori Benn
• Lesly Matthew Benodin, PA-C
• Jon A. Bergeron Jr., P.H.D.
• Gadiel A Berrio, M.D.

• Optometrist in College Station, TX
• Providers in College Station, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.