Provider Demographics
NPI:1659375616
Name:BOND, JAMES RAY JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RAY
Last Name:BOND
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1615 LANCASTER DR
Mailing Address - Street 2:STE 107
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-2111
Mailing Address - Country:US
Mailing Address - Phone:817-488-5555
Mailing Address - Fax:817-421-0400
Practice Address - Street 1:1615 LANCASTER DRIVE
Practice Address - Street 2:STE 107
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-2111
Practice Address - Country:US
Practice Address - Phone:817-488-5555
Practice Address - Fax:817-421-0400
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-08
Last Update Date:2014-01-08
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Provider Licenses
StateLicense IDTaxonomies
TXH1928207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1153967-0Medicaid
TX1153967-0Medicaid
E38827Medicare UPIN