Healthcare Provider Details

I. General information

NPI: 1689092298
Provider Name (Legal Business Name): BETHANY ROSE CARTWRIGHT M.D., PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2014
Last Update Date: 08/05/2022
Certification Date: 08/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2350 N STEMMONS FWY
DALLAS TX
75207-2700
US

IV. Provider business mailing address

5323 HARRY HINES BLVD
DALLAS TX
75390-7201
US

V. Phone/Fax

Practice location:
  • Phone: 214-456-2735
  • Fax:
Mailing address:
  • Phone: 214-456-5959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberS1367
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: