Healthcare Provider Details

I. General information

NPI: 1104283852
Provider Name (Legal Business Name): BETHANY MARIE HOOK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2016
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10260 N CENTRAL EXPY STE 210
DALLAS TX
75231-3426
US

IV. Provider business mailing address

3129 RIDGEMOOR DR
GARLAND TX
75044-6519
US

V. Phone/Fax

Practice location:
  • Phone: 469-729-6459
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1170320
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: