Bethea, Amber D
Bethea, Amber D is an individual health care provider with primary practice located at 2604 Saint Michael Dr Ste 425 , Texarkana TX 75503-2378. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Bethea, Amber D can be contacted via phone (903) 614-5600.Contact Information
Primary practice address
2604 Saint Michael Dr Ste 425
Texarkana TX 75503-2378
Phone: (903) 614-5600
Fax: (903) 614-5630
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | C02148 | Maryland |
Profile Details
| NPI number | 1578526901 |
|---|---|
| LBN Legal business name | Bethea, Amber D |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 7th, 2006 |
| Last updated | May 29th, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578526901 | NPPES |
| Maryland | Other | P00187315 | R/R MEDICARE PROVIDER # |
| Maryland | Other | CA8374 | R/R MEDICARE PROVIDER # |
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