Provider Demographics
NPI:1811059819
Name:BENT TREE FAMILY PHYSICIANS, PA
Entity type:Organization
Organization Name:BENT TREE FAMILY PHYSICIANS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GUY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CULPEPPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-377-8800
Mailing Address - Street 1:17110 DALLAS PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1167
Mailing Address - Country:US
Mailing Address - Phone:972-377-8800
Mailing Address - Fax:972-377-8808
Practice Address - Street 1:3550 PARKWOOD BLVD
Practice Address - Street 2:SUITE 600
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-1903
Practice Address - Country:US
Practice Address - Phone:972-377-8800
Practice Address - Fax:972-377-8808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00650ZMedicare ID - Type UnspecifiedGROUP NUMBER