Individual provider Active NPI

Anne-Marie Ethier Hain, M.D.

  • Developmental - Behavioral Pediatrics Physician
  • Fort Worth, TX
National Provider Identifier
1730154493
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
P4176 Issued in TX
Practice address
1300 W Lancaster Ave Ste 205
Fort Worth, TX 76102-3490
Phone
(817) 336-8611
Fax
(817) 390-2981
NPI assigned
Feb 17, 2006
Last updated
Dec 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X P4176 TX
Developmental - Behavioral Pediatrics Physician 2080P0006X P4176 TX Primary

Addresses

Primary practice location

1300 W Lancaster Ave Ste 205
Fort Worth, TX 76102-3490

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-1855

Other names 1

  • Anne-Marie McDonald Ethier Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160201002466 TX Practitioner - Pediatric Medicine 4981908647 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jan 4, 2016 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Pediatrics CurrentSince Jan 4, 2016 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
Cook Children's Medical Center PastSince Dec 15, 2019 Accepting new patients

Locations

2222 Welborn St
Dallas, TX 75219
Phone (214) 559-5000

420 E 6th St
Ste 202
Odessa, TX 79761
Phone (214) 648-9618

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1730154493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-1855",
            "fax_number": "682-885-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W LANCASTER AVE STE 205",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761023490",
            "telephone_number": "817-336-8611",
            "fax_number": "817-390-2981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIN",
        "first_name": "ANNE-MARIE",
        "middle_name": "ETHIER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P4176",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "TX",
            "license": "P4176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNE-MARIE",
            "last_name": "ETHIER",
            "middle_name": "MCDONALD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.