Vicki Benton Roth, DVM
Individual provider Active NPI Veterinarian · Menard, TX
NPI 1609112150 · NPPES record last updated Jan 2, 2013
Key facts
- NPI
- 1609112150
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Veterinarian 174M00000X
- License
- 5001 (TX)
- Practice address
- 1110 Gay St
Menard, TX 76859 - Phone
- (832) 392-9040
- NPI assigned
- Jan 2, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5001 | TX | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Veterinarian | 174M00000X | 5001 | TX | Yes |
Addresses
Primary practice location
1110 Gay St
Menard, TX 76859
Mailing address
PO Box 546
Menard, TX 76859-0546
Phone (832) 392-9040
Other providers in Menard, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 2, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.