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Individual

DR. BOBBY G. BENNETT JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2411 FOUNTAIN VIEW DR, STE. 200, HOUSTON, TX 77057-4817
(713) 620-4000
Mailing address
2411 FOUNTAIN VIEW DR, STE. 200, HOUSTON, TX 77057-4817
(713) 620-4000

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
H6045
TX
207LP2900X
Pain Medicine (Anesthesiology) Physician
H6045
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1508808411
BCBSTX
TX
01
8V0493
BCBSTX
TX
Enumeration date
06/12/2006
Last updated
08/29/2012
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