Provider Demographics
NPI:1225542384
Name:MORRIS, BETHANY LYNN (PA-C)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:LYNN
Last Name:MORRIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 N ZANG BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-4263
Mailing Address - Country:US
Mailing Address - Phone:214-941-4243
Mailing Address - Fax:214-941-1153
Practice Address - Street 1:810 N ZANG BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-4263
Practice Address - Country:US
Practice Address - Phone:214-941-4243
Practice Address - Fax:214-941-1153
Is Sole Proprietor?:No
Enumeration Date:2017-11-28
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant