Individual
BETHANY G RUNKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1500 COOPER ST, FORT WORTH, TX 76104-2710
(682) 885-2140
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-6483
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2014019471
MO
2080P0202X
Pediatric Cardiology Physician
Primary
S8111
TX
Other
Enumeration date
04/18/2014
Last updated
04/06/2021
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