Bethany Bonifant

NPI 1225644743 · on the registry since 2020 · sole proprietor

Practice

Address: 5301 Bryant Irvin Rd
Fort Worth, TX 76132
Phone: (817) 422-0561
Organisation at this address: Fort Austin Limited Partnership
Watermark Broadway Cityview, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 7

Registry record

Primary taxonomy: 235Z00000X
235Z00000X
Licence states on file: TX
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2023-11-27

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas