Basic Information
| Provider Information | |||||||||
| NPI: | 1649207986 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BENTZ | ||||||||
| FirstName: | ALAN | ||||||||
| MiddleName: | ELLIOTT | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 202287 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753202287 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002610048 | ||||||||
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| Practice Location | |||||||||
| Address1: | 710 FM 1960 RD W | ||||||||
| Address2: | EMERGENCY DPT | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770903402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814402146 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2006 | ||||||||
| LastUpdateDate: | 03/30/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207PE0004X | K4369 | TX | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | Emergency Medical Services |
No ID Information.