Provider Demographics
NPI:1801123872
Name:STEEN, BONNIE JO (PA-C)
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:JO
Last Name:STEEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:BONNIE
Other - Middle Name:JO
Other - Last Name:BENNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2931 PERRYTON PKWY
Mailing Address - Street 2:
Mailing Address - City:PAMPA
Mailing Address - State:TX
Mailing Address - Zip Code:79065-2823
Mailing Address - Country:US
Mailing Address - Phone:806-669-1200
Mailing Address - Fax:806-669-1210
Practice Address - Street 1:2931 PERRYTON PKWY
Practice Address - Street 2:
Practice Address - City:PAMPA
Practice Address - State:TX
Practice Address - Zip Code:79065-2823
Practice Address - Country:US
Practice Address - Phone:806-669-1200
Practice Address - Fax:806-669-1210
Is Sole Proprietor?:No
Enumeration Date:2009-11-11
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06407363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant