Provider Demographics
NPI:1700065323
Name:THE BOND GROUP
Entity Type:Organization
Organization Name:THE BOND GROUP
Other - Org Name:TOTAL CARE HEALTH AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:K
Authorized Official - Last Name:BOND
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MS
Authorized Official - Phone:337-264-7209
Mailing Address - Street 1:913 S COLLEGE RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-3060
Mailing Address - Country:US
Mailing Address - Phone:337-264-7209
Mailing Address - Fax:337-264-7214
Practice Address - Street 1:913 S COLLEGE RD
Practice Address - Street 2:SUITE 106
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3060
Practice Address - Country:US
Practice Address - Phone:337-264-7209
Practice Address - Fax:337-264-7214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA15178R207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4F466Medicare PIN
H94424Medicare UPIN