Individual
DR. DONALD BENNETT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
215 OAK DR S, SUITE B, LAKE JACKSON, TX 77566-5629
(979) 297-6436
(979) 297-0582
Mailing address
215 OAK DR S, SUITE B, LAKE JACKSON, TX 77566-5629
(979) 297-6436
(979) 297-0582
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
E0811
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
SOCIAL SECURITY
TX
Enumeration date
12/05/2005
Last updated
05/21/2020
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