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Contact Information

ETHAN BOOTHE, MD
815 PENNSYLVANIA AVE
FORT WORTH, TX76104-2224
 Phone: 817-321-0404
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
Indicates primary specialty

NPI Profile & details for ETHAN BOOTHE · (Male)

NPI Number 1508209495
Status Active
Credentials MD
Entity Individual
Enumeration date 04/10/2013
Last updated 07/30/2025 - About 10 months ago
Sole proprietor 1 No
Identifiers
  • TX License # Q2741
Hospital affiliation(s)
  • JPS HEALTH NETWORK - (Acute Care)
    1500 S MAIN ST
    FORT WORTH, TX 76104
  • MEDICAL CITY DALLAS HOSPITAL - (Acute Care)
    7777 FOREST LANE
    DALLAS, TX 75230
  • MOTHER FRANCES HOSPITAL - (Acute Care)
    800 EAST DAWSON
    TYLER, TX 75701
  • NORTHWEST TEXAS HOSPITAL - (Acute Care)
    1501 COULTER ROAD
    AMARILLO, TX 79106
  • TEXOMA MEDICAL CENTER - (Acute Care)
    5016 S US HIGHWAY 75
    DENISON, TX 75020
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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