Individual
ANDREW E BENTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13082 COUNTY ROAD 2320, TYLER, TX 75707-5914
(903) 245-9647
Mailing address
13082 COUNTY ROAD 2320, TYLER, TX 75707-5914
(903) 245-9647
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
J8455
TX
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
J8455
TX
208M00000X
Hospitalist Physician
Primary
J8455
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1599359-01
—
TX
01
—
8G6450
BLUE CROSS BLUE SHIELD
TX
Enumeration date
08/15/2006
Last updated
01/24/2023
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