Provider Demographics
NPI:1871042176
Name:ONDARI, ISABELLA BOSIBORI
Entity Type:Individual
Prefix:
First Name:ISABELLA
Middle Name:BOSIBORI
Last Name:ONDARI
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 1:4621 BUFFALO BEND PL
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76137-6168
Mailing Address - Country:US
Mailing Address - Phone:817-727-7458
Mailing Address - Fax:
Practice Address - Street 1:1411 STONE CANYON DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-1973
Practice Address - Country:US
Practice Address - Phone:877-615-1265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131813363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily