Provider Demographics
NPI:1912539842
Name:3RD GEN BOND ENTERPRISES, LLC
Entity Type:Organization
Organization Name:3RD GEN BOND ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ATAHSIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:SMILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-526-3116
Mailing Address - Street 1:17250 DALLAS PKWY STE 27
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1136
Mailing Address - Country:US
Mailing Address - Phone:469-526-3116
Mailing Address - Fax:
Practice Address - Street 1:17250 DALLAS PKWY STE 27
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-1136
Practice Address - Country:US
Practice Address - Phone:469-526-3116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-09
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No261QM1102XAmbulatory Health Care FacilitiesClinic/CenterMilitary Outpatient Operational (Transportable) Component
No261QM1103XAmbulatory Health Care FacilitiesClinic/CenterMilitary Ambulatory Procedure Visits Operational (Transportable)
No2865X1600XHospitalsMilitary HospitalMilitary General Acute Care Hospital. Operational (Transportable)
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies