Individual
DR. JOHN DIETER BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4645 SAMUELL BLVD, DALLAS, TX 75228-6826
(214) 905-0595
(214) 905-0979
Mailing address
4645 SAMUELL BLVD, DALLAS, TX 75228-6826
(214) 275-7393
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
H9792
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
039795201
—
TX
Enumeration date
08/11/2006
Last updated
11/10/2025
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