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Organization

BENTRY NO. 1, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JO LEAH MONTGOMERY (MANAGER)
(214) 454-4542
Entity
Organization

Contact information

Practice address
2517 TIMBER COVE LN, PLANO, TX 75093-8832
(972) 370-5989
Mailing address
1141 N LOOP 1604 E # 105-612, SAN ANTONIO, TX 78232-1339
(855) 598-2800

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Enumeration date
03/02/2020
Last updated
05/11/2022
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