Individual
MARTY NEAL BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16479 DALLAS PKWY STE 320, ADDISON, TX 75001-6709
(469) 484-4260
(469) 484-4265
Mailing address
16479 DALLAS PKWY STE 320, ADDISON, TX 75001-6709
(469) 484-4260
(469) 484-4265
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
L0029
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151750001
—
TX
Enumeration date
04/05/2006
Last updated
04/06/2021
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