Provider Demographics
NPI:1316938350
Name:AHRENDT, DALE M (MD)
Entity type:Individual
Prefix:DR
First Name:DALE
Middle Name:M
Last Name:AHRENDT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:BROOKE ARMY MEDICAL CENTER MCHE-QD/ CREDENTIALS
Mailing Address - Street 2:3551 ROGER BROOKE DRIVE
Mailing Address - City:FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-6200
Mailing Address - Country:US
Mailing Address - Phone:210-916-4735
Mailing Address - Fax:210-916-6349
Practice Address - Street 1:3551 ROGER BROOKE DR
Practice Address - Street 2:
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-916-4735
Practice Address - Fax:210-916-6349
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2020-08-11
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Provider Licenses
StateLicense IDTaxonomies
SD42342080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine