Individual
GLEN ALLEN BENNION
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
701 W 5TH ST, ODESSA, TX 79763-4206
(432) 703-5083
Mailing address
701 W 5TH ST, ODESSA, TX 79763-4206
(432) 703-5083
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
T7494
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
TX
Other
Enumeration date
04/30/2018
Last updated
07/05/2022
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