Individual
DR. TAMAR BENNETSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3010 STARDUST LN, NORTHLAKE, TX 76226-1763
(915) 497-2179
Mailing address
3010 STARDUST LN, NORTHLAKE, TX 76226-1763
(915) 497-2179
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
4205
AZ
Other
Enumeration date
02/10/2021
Last updated
02/10/2021
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