Individual
DR. JASON M. BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12838 VISTA DEL NORTE, SAN ANTONIO, TX 78216-8112
(361) 649-8434
(210) 614-1055
Mailing address
PO BOX 791110, SAN ANTONIO, TX 78279-1110
(210) 757-4677
(210) 614-1055
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
K1359
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
089904901
—
TX
Enumeration date
07/26/2006
Last updated
11/15/2024
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