Individual
TYLER BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 W. MOCKINGBIRD LN., #480, DALLAS, TX 75247
(972) 489-5552
Mailing address
301 MOONLIGHT TRL, WAXAHACHIE, TX 75165-8825
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/12/2023
Last updated
04/12/2023
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