Provider Demographics
NPI:1619558756
Name:BONDS, VIRGINIAH W
Entity Type:Individual
Prefix:
First Name:VIRGINIAH
Middle Name:W
Last Name:BONDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 VALLEY VIEW DR APT 605
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-7777
Mailing Address - Country:US
Mailing Address - Phone:325-439-3144
Mailing Address - Fax:
Practice Address - Street 1:146 VALLEY VIEW DR APT 605
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-7777
Practice Address - Country:US
Practice Address - Phone:325-439-3144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1028700363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily