# DR. ETHAN BERNELL DALLEY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1780818112
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | P9063 | TX | Yes |

## Other

- **Enumeration date:** 05/13/2009
- **Last updated:** 07/21/2022