Provider Demographics
NPI:1558092551
Name:MORTON, BONIQUE P (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:BONIQUE
Middle Name:P
Last Name:MORTON
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:852 LONGBRANCH WAY
Mailing Address - Street 2:
Mailing Address - City:AUBREY
Mailing Address - State:TX
Mailing Address - Zip Code:76227-1830
Mailing Address - Country:US
Mailing Address - Phone:330-646-1989
Mailing Address - Fax:
Practice Address - Street 1:852 LONGBRANCH WAY
Practice Address - Street 2:
Practice Address - City:AUBREY
Practice Address - State:TX
Practice Address - Zip Code:76227-1830
Practice Address - Country:US
Practice Address - Phone:330-646-1989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath