Individual
BETHANY GARRISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C, LAT
Contact information
Practice address
1283 RECORD CROSSING RD, DALLAS, TX 75235-6001
(214) 941-1050
Mailing address
1283 RECORD CROSSING RD, DALLAS, TX 75235-6001
(214) 941-1050
(214) 946-4738
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
363A00000X
Physician Assistant
Primary
—
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZGP847363746
BLUE CROSS BLUE SHIELD
TX
Enumeration date
08/23/2018
Last updated
08/11/2026
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