Provider Demographics
NPI:1922465319
Name:BOUNSING, JUNE
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:
Last Name:BOUNSING
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 1:5012 US HWY 75 S, SUITE 300
Mailing Address - Street 2:ATTN. BILLING
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020
Mailing Address - Country:US
Mailing Address - Phone:806-351-7530
Mailing Address - Fax:
Practice Address - Street 1:1900 SE 34TH AVE
Practice Address - Street 2:SUITE 1700
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79118-7771
Practice Address - Country:US
Practice Address - Phone:806-351-7530
Practice Address - Fax:806-351-7539
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-15
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX803764163W00000X
TXAP130143363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3542128-01Medicaid
TX473418ZHHLMedicare PIN