Basic Information
| Provider Information | |||||||||
| NPI: | 1003044348 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAUMGART | ||||||||
| FirstName: | BETHANY | ||||||||
| MiddleName: | LYN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | AU.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | PIPES | ||||||||
| OtherFirstName: | BETHANY | ||||||||
| OtherMiddleName: | LYN | ||||||||
| OtherNamePrefix: | MISS | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | AU.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 5303 HARRY HINES BLVD | ||||||||
| Address2: | DEPARTMENT OF OTOLARYNGOLOGY | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753909035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2146458898 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5303 HARRY HINES BLVD | ||||||||
| Address2: | DEPARTMENT OF OTOLARYNGOLOGY | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753909035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2146458898 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2009 | ||||||||
| LastUpdateDate: | 12/14/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 80133 | TX | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.