Bennett T Gardner, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

G1904 Issued in TX

Practice address

4401 Booth Calloway Rd
North Richland Hills, TX 76180-7371

Phone

(972) 758-3598

NPI assigned

Dec 15, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1316923097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 201606",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753201606",
            "telephone_number": "972-758-3598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 BOOTH CALLOWAY RD",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761807371",
            "telephone_number": "972-758-3598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "BENNETT",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "G1904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "86790N",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara Eichhorn Gallagher, D.O.
• Kanti C Gandhi, M.D.
• Kristine Tan Gapuz, MD
• Eric Garcia
• Jorge A Garcia, LPC
• Sarah V Gardner, D.O.
• Cleveland Martin Garrison, PHARMD
• Alexis Dion Gathers, COTA/L
• Laurence T Gayao, M.D.
• Frank Robert Genco, M.D.

• Emergency Medicine Physician in North Richland Hills, TX
• Providers in North Richland Hills, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.