BETHANY WIMBERLY (NPI# 1407237316) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407237316 |
| Entity Type | Individual |
| Full Name | BETHANY WIMBERLY |
| Practice Address |
3095 Kingswood Blvd Ste 250 Grand Prairie TX 75052 |
| Mailing Address |
3095 Kingswood Blvd Ste 250 Grand Prairie TX 75052-4502 |
| Practice Telephone | 9728171950 |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2019-02-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | R6940 | TX | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 900 8th Ave, Fort Worth, TX 761043902 | 8178775292 | |
| 5941 Riverbend Pl, Fort Worth, TX 761121063 | 2547092704 |
| Street Address |
3095 KINGSWOOD BLVD STE 250 |
| City | GRAND PRAIRIE |
| State | TX |
| Zip Code | 75052 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487265542 | Beyond Home Health Care LLC | Registered Nurse | 3531 Pecos Way, Grand Prairie, TX 75052 | 2020-08-12 |
| 1497370332 | Michael Cooper | Dentist | 3154 South Hwy 161 Ste 640, Grand Prairie, TX 75052 | 2020-06-16 |
| 1043835788 | Amanda Azubike | Licensed Practical Nurse | 4593 Mt Laurel Dr, Grand Prairie, TX 75052 | 2020-06-09 |
| 1457992844 | Epic West Family Dnetistry Pllc | Dentist | 3166 Sh 161, Ste 190, Grand Prairie, TX 75052 | 2019-10-07 |
| 1033777487 | National Vision Inc | Optometrist | 3166 South Highway 161, Suite 160, Grand Prairie, TX 75052 | 2019-05-31 |
| 1689136624 | Raushanah Taherrah Shareef-jefferson | Dental Hygienist | 831 Ridgecrest Rd, Grand Prairie, TX 75052 | 2019-04-01 |
| 1053812552 | Dfw Better Care Physicians, Pllc | Clinic/Center | 5204 Tx 360 #400, Grand Prairie, TX 75052 | 2018-02-21 |
| 1629586797 | Grand Prairie Marvel Dental Pllc | Clinic/Center | 5020 S Hwy 360, Suite 200, Grand Prairie, TX 75052 | 2018-01-11 |
| 1033626221 | Thad Taylor Iv Dds | Dentist | 3261 S. Carrier Pkwy., Grand Prairie, TX 75052 | 2018-01-09 |
| 1902312796 | Real Dental Pllc | Dentist | 1215 W. Pioneer Pkwy, Suite 130, Grand Prairie, TX 75052 | 2017-12-16 |
| Find all providers in zip 75052 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427673375 | Imd Healthcare Association, Inc. | Family Medicine | 5857 Tory Dr, Grand Prairie, TX 75052-8500 | 2020-06-16 |
| 1134686926 | Grand Prairie Physician Group LLC | Family Medicine | 517 N Carrier Pkwy Ste J, Grand Prairie, TX 75050-5484 | 2019-02-27 |
| 1922533322 | Kelly Walthius | Family Medicine | 2740 N State Highway 360 Ste 100, Grand Prairie, TX 75050-6402 | 2017-04-24 |
| 1699158964 | Gp Medical Management Group Inc | Family Medicine | 2634 S Carrier Pkwy Ste 105, Grand Prairie, TX 75052-5005 | 2015-07-06 |
| 1285047514 | Shaun Gould | Family Medicine | 2740 N Hwy 360 Ste 100, Grand Prairie, TX 75050-6402 | 2014-06-04 |
| 1841543097 | Omni Pain Clinic Inc | Family Medicine | 513 W Jefferson Blvd., Suite 170, Grand Prairie, TX 75051-1639 | 2012-10-24 |
| 1013238401 | Ahmad Ghassan Abazid | Family Medicine | 4927 Lake Ridge Pkwy Ste 100, Grand Prairie, TX 75052 | 2010-06-20 |
| 1912157819 | Cynthia Denise Mckinney | Family Medicine | 2520 W Interstate 20, Grand Prairie, TX 75052-7280 | 2008-09-26 |
| 1164697850 | Crystal Renee Foster | Family Medicine | 4927 Lakeridge Pkwy, Suite 100, Grand Prairie, TX 75052-3087 | 2008-04-24 |
| 1932395514 | Nahn Ta | Family Medicine | 5047 Barcelona Trl, Grand Prairie, TX 75052-0937 | 2007-09-18 |
| Find all providers in GRAND PRAIRIE | ||||
| City | GRAND PRAIRIE |
| Zip Code | 75052 |
Please comment or provide details below to improve the information on BETHANY WIMBERLY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.