KEVIN L BENHAM (10665TG OD) – Optometrist, NPI 1336479724

KEVIN L BENHAM (10665TG OD) is a healthcare provider. based in College station, Texas. specializing in Optometrist. They hold the professional credentials 10665TG OD. They hold a License No. 7932TG (TX). The NPI Number for KEVIN L BENHAM (10665TG OD) is 1336479724

Main info

Male
17 Years Of Experience
Accepts Medicare Assignment
Name
KEVIN L BENHAM (10665TG OD)
NPI
1336479724
Phone
(979) 321-6565
Address
4321 STATE HIGHWAY 6
Enumeration Date
6 January 2010
Last Update Date
29 July 2022

Doctor Profile

Medical School Name
UNIVERSITY OF HOUSTON - COLLEGE OF OPTOMETRY
Secondary Phone
-
Graduation Year
2009 (17 years ago)
PAC ID
4688837396
Professional Enrollment ID
I20120516000498
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience74
Completeness75
Years active:16State licenses:3Digital endpointsOther names

Provider Addresses for KEVIN L BENHAM (10665TG OD)

  • 4321 STATE HIGHWAY 6

    COLLEGE STATION, TX 77845

    Phone: (979) 321-6565

    Fax: (979) 321-6566

    Type: Location

  • 3310 B FM 967

    SUITE A-108

    BUDA, TX 78610

    Phone: (512) 295-0076

    Fax: (512) 312-4265

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-05-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120516000498IOptometryTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 77845)

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Reviews

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Frequently asked questions

How do I look up KEVIN L BENHAM (10665TG OD) by NPI?
Use NPI 1336479724 when you need to reference KEVIN L BENHAM (10665TG OD) in forms, claims, or directories.
Is KEVIN L BENHAM (10665TG OD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does KEVIN L BENHAM (10665TG OD) list a primary specialty?
If you are matching referrals, note Optometrist for KEVIN L BENHAM (10665TG OD). Clinical services aligned with this taxonomy classification.
What location shows for KEVIN L BENHAM (10665TG OD)?
We surface College Station, Texas for KEVIN L BENHAM (10665TG OD) based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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