Provider Demographics
NPI:1841791597
Name:BENDER, PRESTON EMERSON (OTD)
Entity type:Individual
Prefix:
First Name:PRESTON
Middle Name:EMERSON
Last Name:BENDER
Suffix:
Gender:M
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3111 SACBE CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-7520
Mailing Address - Country:US
Mailing Address - Phone:512-222-8133
Mailing Address - Fax:737-277-5585
Practice Address - Street 1:3111 SACBE CV
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-7520
Practice Address - Country:US
Practice Address - Phone:512-222-8133
Practice Address - Fax:737-277-5585
Is Sole Proprietor?:No
Enumeration Date:2018-02-27
Last Update Date:2025-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX126062225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist