Individual
KANDON BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
224 E 2ND ST, DUMAS, TX 79029-3808
(806) 935-7171
Mailing address
PO BOX 405, HENRIETTA, TX 76365-0405
(940) 631-2796
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA19602
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/30/2025
Last updated
11/02/2025
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