Provider Demographics
NPI:1679644371
Name:GEORGE, BETSY ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:BETSY
Middle Name:ANN
Last Name:GEORGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BETSY
Other - Middle Name:ANN
Other - Last Name:VARGHESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:621 N HALL ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75226-1339
Mailing Address - Country:US
Mailing Address - Phone:214-824-8721
Mailing Address - Fax:214-237-6529
Practice Address - Street 1:621 N HALL ST
Practice Address - Street 2:SUITE 400
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75226-1339
Practice Address - Country:US
Practice Address - Phone:214-824-8721
Practice Address - Fax:214-237-6529
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4084207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX186129603Medicaid
TX186129604Medicaid
TX186129605Medicaid
TX186129604Medicaid
TX314208YKY6Medicare PIN