Provider Demographics
NPI:1093709511
Name:BONDS, JAMES VAULL JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:VAULL
Last Name:BONDS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4103 LAKE LAND DRIVE
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-9655
Mailing Address - Country:US
Mailing Address - Phone:979-764-7983
Mailing Address - Fax:
Practice Address - Street 1:1602 ROCK PRAIRE ROAD #320
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845
Practice Address - Country:US
Practice Address - Phone:979-764-7983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-12
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6061207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH6061OtherMEDICAL LICENCE
TXH6061OtherMEDICAL LICENCE
TXE90979Medicare UPIN