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General NPI Number Information
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NPI Number | 1518906825
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Entity Type | Individual
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Provider Name | ROBERT DANIEL BENNETT MD
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Gender | Male
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 6800 W INTERSTATE 10 STE 200
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City | SAN ANTONIO
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State | TX
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Zip | 78201-2041
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Country | US
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Telephone | 210-519-5797
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Fax | 210-579-7027
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Provider Business Mailing Address
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Address Line | 6800 W INTERSTATE 10 STE 200
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City | SAN ANTONIO
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State | TX
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Zip | 78201-2041
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Country | US
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Telephone | 210-519-5797
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Fax | 210-579-7027
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 28320
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD047496L
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | N0642
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License Number State | TX
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