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Emmanuel E Benjamin-Echedom

Physician β€’ Van Alstyne, TX

Deactivated NPI 1679430466 Deactivated in NPPES
Practice location in NPPES

645 Blassingame Ave Apt F212
Van Alstyne, TX 754953040

Phone: 8173663512

Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

This NPI Is Deactivated in NPPES

NPPES lists this NPI as deactivated as of May 07, 2026; the reason is not published. The records below are historical. They do not show whether Emmanuel Benjamin-Echedom currently practices or holds a license; check the state medical board for current license status.

NPI Enumeration Date January 05, 2026
NPI Deactivation Date May 07, 2026
NPI Active Period 2026 – 2026

Practice Location & Contact Primary Location

Practice Address

645 Blassingame Ave Apt F212

Van Alstyne, TX 754953040

Telephone 8173663512
Organization at the Same NPPES Address or Phone
Reliablerid Facility NPI 1306773718

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2026

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Compared with the same specialty in Van Alstyne and Texas

Comparisons are not shown because NPPES lists this NPI as deactivated.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Non-emergency Medical Transport (VAN) Primary Specialty

NUCC Taxonomy Code: 343900000X

License # reported to NPPES TX 28720879

A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Texas Medical Board.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
⚠️
NPI Profile Deactivated May 07, 2026

NPPES lists this NPI as deactivated as of May 07, 2026; the reason is not published.

βœ…
NPI Profile Active January 05, 2026

NPI status registered as active in NPPES database

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Practice Location (Initial Record) January 05, 2026

Registered at 645 BLASSINGAME AVE APT F212, VAN ALSTYNE, TX 754953040 (Tel: 8173663512)

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Business Mailing Address (Initial Record) January 05, 2026

Registered at 6016 MCKASKLE DR, FORT WORTH, TX 761191608 (Tel: 8173663512)

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Provider Name / Credentials (Initial Record) January 05, 2026

Recorded as EMMANUEL BENJAMIN-ECHEDOM

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 05, 2026

Non-emergency Medical Transport (VAN) (license number reported to NPPES: TX 28720879)

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Initial NPI Registration & Enumeration January 05, 2026

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1679430466
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 05, 2026
Last Update: January 05, 2026
Deactivation Date: May 07, 2026

Mailing Address

6016 Mckaskle Dr

Fort Worth, TX 761191608

Phone: 8173663512

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.