Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | M1506 | TX |
NPI | 1083708739 |
---|---|
Provider Name | Dr. Martin M Behnke |
First Address | Dallas, TX 75225-6532 |
Second Address | Dallas, TX 75225-6532 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 03/01/2012 |