Provider Demographics
NPI:1386095008
Name:BENNETT, BRIAN (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:BENNETT
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 GOSLING RD
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-4845
Mailing Address - Country:US
Mailing Address - Phone:281-719-7673
Mailing Address - Fax:
Practice Address - Street 1:8600 GOSLING RD
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381-4845
Practice Address - Country:US
Practice Address - Phone:281-719-7673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP69502083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine