MEDICARE: BETHANY HART PA-C

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
1	363AM0700X	Medical Physician Assistant	PA13327	TX

General Provider Information

NPI Number	:	1528616588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETHANY HART PA-C

Provider Business Mailing Address
First Line	:	104 E HIGHLAND MALL BLVD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78752-3775
Country	:	US
Telephone Number	:	512-458-2437
Fax Number	:	833-393-3915

Provider Business Practice Location Address
First Line	:	104 E HIGHLAND MALL BLVD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78752-3775
Country	:	US
Telephone Number	:	512-458-2437
Fax Number	:	833-393-3915

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2019
Last Update Date	:	04/15/2026

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Directions to “ BETHANY HART PA-C” Practice Location

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