Doctor Name: | DR. JAMES GREGORY BONNEN |
NPI Number: | 1003812264 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | J3995 |
Business Practice Address: | 333 N Texas Ave Suite 3200 Webster, TX - 775984966 |
Business Phone Number: | 2819225099 |
Business Fax Number: | 2819225490 |
Mailing Address: | 333 N Texas Ave, Suite 3200 WEBSTER |
State: | TX |
Postal Code: | 775984966 |
Phone Number: | 2819225099 |
Fax Number: | 2819225490 |
NPI Enumeration Date: | 06/22/2005 |
NPI Last Update Date: | 09/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | J3995 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |