Provider Demographics
NPI:1558549394
Name:JONES, SARAH BETHANY (CPM, LM)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:BETHANY
Last Name:JONES
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2260 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76110-1942
Mailing Address - Country:US
Mailing Address - Phone:817-219-9293
Mailing Address - Fax:817-796-1729
Practice Address - Street 1:409 W WALL ST
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-5203
Practice Address - Country:US
Practice Address - Phone:817-479-0124
Practice Address - Fax:817-796-1729
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-04
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99053176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife