Provider Demographics
NPI:1508043027
Name:JAMES V BONNET, M.D., P.A.
Entity Type:Organization
Organization Name:JAMES V BONNET, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:V
Authorized Official - Last Name:BONNET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-481-2088
Mailing Address - Street 1:1600 W COLLEGE ST
Mailing Address - Street 2:SUITE 140
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-3580
Mailing Address - Country:US
Mailing Address - Phone:817-481-2088
Mailing Address - Fax:817-488-3536
Practice Address - Street 1:1600 W COLLEGE ST
Practice Address - Street 2:SUITE 140
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-3580
Practice Address - Country:US
Practice Address - Phone:817-481-2088
Practice Address - Fax:817-488-3536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6457174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00W362OtherMEDICARE PROVIDER