Provider Demographics
NPI:1235525064
Name:BARTH, BETHANIE (FNP)
Entity type:Individual
Prefix:
First Name:BETHANIE
Middle Name:
Last Name:BARTH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10107 LOUETTA RD STE 105
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-1574
Mailing Address - Country:US
Mailing Address - Phone:210-992-2654
Mailing Address - Fax:
Practice Address - Street 1:10107 LOUETTA RD STE 105
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-1574
Practice Address - Country:US
Practice Address - Phone:210-992-2654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1059333363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily