Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ethan Boothe, MD

Individual provider Diagnostic Radiology Physician · NPI 1508209495

Ethan Boothe, MD is a Diagnostic Radiology in Fort Worth, Texas. Graduated from Louisiana State University School of Medicine in Shreveport in 2013, 13 years ago. Practices with Radiology Associates of North Texas PA, a 341-clinician group. Licensed in Texas.

Years since qualifying
13
Trained at
Louisiana State University School of Medicine in Shreveport
Licensed in
TX
In the registry since
2013
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

815 Pennsylvania Ave
Fort Worth, TX 76104-2224
Phone: (817) 321-0404
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence Q2741 (TX)

Record details

NPI number1508209495
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 10, 2013
Last updated in NPPESJuly 30, 2025
Certification dateJuly 30, 2025
Mailing address816 W Cannon St, Fort Worth, TX 76104-3146

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolLOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
Graduated 2013 (13 years in practice)
Group practice Radiology Associates Of North Texas Pa — 341 clinicians
Accepts Medicare assignment Not indicated
Practice locations4 on file with Medicare

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