| Mrs Amber D Bethea, PA-C | |
|
2604 Saint Michael Dr Ste 425, Texarkana, TX 75503-2378 | |
| (903) 614-5600 | |
| (903) 614-5630 |
| Full Name | Mrs Amber D Bethea |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant - Surgical |
| Location | 2604 Saint Michael Dr Ste 425, Texarkana, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578526901 | NPI | - | NPPES |
| P00187315 | Other | MD | R/R MEDICARE PROVIDER # |
| CA8374 | Other | MD | R/R MEDICARE GROUP # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AS0400X | Physician Assistant - Surgical | C02148 (Maryland) | Primary |
| Entity Name | Physician Assistant Services of Texas L.l.p |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164467692 PECOS PAC ID: 2062303803 Enrollment ID: O20040322001761 |
| Entity Name | C H Wilkinson Physician Network |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457382947 PECOS PAC ID: 8921919580 Enrollment ID: O20041203000584 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Amber D Bethea, PA-C 2900 Saint Michael Dr Ste 401, Texarkana, TX 75503-5211 Ph: (903) 614-5393 | Mrs Amber D Bethea, PA-C 2604 Saint Michael Dr Ste 425, Texarkana, TX 75503-2378 Ph: (903) 614-5600 |
William Bowling, P.A Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5002 Cowhorn Creek Rd, Texarkana, TX 75503 Phone: 903-614-3000 Fax: 903-614-3525 |
Matthew Nathan Sparks, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1400 College Dr, Texarkana, TX 75503 Phone: 903-791-1110 |
Jennifer Siskron Ogle, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1920 Galleria Oaks Dr, Texarkana, TX 75503 Phone: 903-792-6114 Fax: 903-792-0582 |
Ms. Cynthiia Collum, RNFA, BSN Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 5420 Medical Parkway Dr, Texarkana, TX 75503 Phone: 903-793-8966 Fax: 903-792-1722 |
Kellie Lyn Flaherty, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2604 Saint Michael Dr, Suite 340, Texarkana, TX 75503 Phone: 903-614-5111 |
Aidan Goodreau, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2604 Saint Michael Dr Ste 425, Texarkana, TX 75503 Phone: 903-614-5641 |
Bryan Spruill, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 5002 Cowhorn Creek Rd, Texarkana, TX 75503 Phone: 903-614-3008 Fax: 903-614-3525 |