Provider Demographics
NPI:1417599143
Name:BENTLEY, CATHERINE ADEBISI (NP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ADEBISI
Last Name:BENTLEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 MESSINA LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-1827
Mailing Address - Country:US
Mailing Address - Phone:832-677-1776
Mailing Address - Fax:
Practice Address - Street 1:1115 MESSINA LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-1827
Practice Address - Country:US
Practice Address - Phone:832-677-1776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-15
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143219363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily