Provider Demographics
NPI:1841803756
Name:MOURA, BETHANY WRIGHT (CPNP-AC)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:WRIGHT
Last Name:MOURA
Suffix:
Gender:F
Credentials:CPNP-AC
Other - Prefix:MS
Other - First Name:BETHANY
Other - Middle Name:ANN
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:7000 FANNIN ST STE 1020
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-5400
Mailing Address - Country:US
Mailing Address - Phone:713-500-3962
Mailing Address - Fax:
Practice Address - Street 1:6410 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3000
Practice Address - Country:US
Practice Address - Phone:888-488-3627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-29
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP1458832080P0203X, 363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care
No2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine