Provider Demographics
NPI:1164741674
Name:HAYASHI, BONNIE HONG (MD)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:HONG
Last Name:HAYASHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 PINE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-2450
Mailing Address - Country:US
Mailing Address - Phone:325-670-5570
Mailing Address - Fax:833-437-1267
Practice Address - Street 1:1904 PINE ST STE 200
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2450
Practice Address - Country:US
Practice Address - Phone:325-670-5570
Practice Address - Fax:833-437-1267
Is Sole Proprietor?:No
Enumeration Date:2010-05-24
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP87862084N0400X, 204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology