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NPI Code Detail

MEDICARE: BETHANY MILLER

MEDICARE: BETHANY MILLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician1226629TX

General Provider Information

NPI Number : 1053274845
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETHANY MILLER
Provider Business Mailing Address
First Line : 5204 N HIGHLAND DR
Second Line :
City : GRANBURY
State : TX
Zip : 76049-2958
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1400 8TH AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-4110
Country : US
Telephone Number : 817-926-2544
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2025
Last Update Date : 02/04/2026

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Directions to “ BETHANY MILLER ” Practice Location

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