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Individual

MR. DAVID THOMAS BENNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
R.PH.

Contact information

Practice address
501 MEDICAL CENTER BLVD, WEBSTER, TX 77598-4219
(281) 316-4926
(281) 316-4991
Mailing address
2307 HAVERHILL DR, HOUSTON, TX 77008-3028
(713) 861-6996
(281) 316-4926

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
31550
TX
183500000X
Pharmacist
RP31661L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
31550
TEXAS PHARMACY LICENSE
TX
01
RP031661L
PENNSYLVANIA PHARMACY LIC
PA
Enumeration date
12/06/2006
Last updated
07/08/2007
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