Provider Demographics
NPI:1760557946
Name:BENTLEY, STEVEN ALAN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:ALAN
Last Name:BENTLEY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5012 S US HIGHWAY 75 STE 120
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-4587
Mailing Address - Country:US
Mailing Address - Phone:903-416-5300
Mailing Address - Fax:903-416-5325
Practice Address - Street 1:5012 S US HIGHWAY 75
Practice Address - Street 2:SUITE 120
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-4587
Practice Address - Country:US
Practice Address - Phone:903-465-2190
Practice Address - Fax:903-465-2262
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA05103363AS0400X, 363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical