Provider Demographics
NPI:1740551191
Name:BEHRENDS, DAVID R (DVM)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:R
Last Name:BEHRENDS
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1494 LOOP 163
Mailing Address - Street 2:
Mailing Address - City:BLANCO
Mailing Address - State:TX
Mailing Address - Zip Code:78606-4792
Mailing Address - Country:US
Mailing Address - Phone:830-833-5140
Mailing Address - Fax:830-833-2196
Practice Address - Street 1:1494 LOOP 163
Practice Address - Street 2:
Practice Address - City:BLANCO
Practice Address - State:TX
Practice Address - Zip Code:78606-4792
Practice Address - Country:US
Practice Address - Phone:830-833-5140
Practice Address - Fax:830-833-2196
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-17
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4485174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4485OtherVET LISCENSE NUMBER