Dr Richard B Bonner, MD | |
1901 Sw H K Dodgen Loop, Temple, TX 76502-1814 | |
(254) 935-4000 | |
Not Available |
Full Name | Dr Richard B Bonner |
---|---|
Gender | Male |
Speciality | Pediatrics - Pediatric Critical Care Medicine |
Location | 1901 Sw H K Dodgen Loop, Temple, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1659331841 | NPI | - | NPPES |
8J5012 | Other | TX | BLUE SHIELD |
1117681-04 | Medicaid | TX | |
P00036792 | Other | TX | RR/MEDICARE |
1117681-06 | Other | TX | CSHCN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | J8468 (Texas) | Secondary |
2080P0203X | Pediatrics - Pediatric Critical Care Medicine | J8468 (Texas) | Primary |
Entity Name | Scott & White Clinic |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1093779704 PECOS PAC ID: 8123923604 Enrollment ID: O20031223000640 |
Mailing Address | Practice Location Address |
---|---|
Dr Richard B Bonner, MD Po Box 844658, Dallas, TX 75284-4658 Ph: (800) 994-0371 | Dr Richard B Bonner, MD 1901 Sw H K Dodgen Loop, Temple, TX 76502-1814 Ph: (254) 935-4000 |
Dr. Ezhilarasi Manickavasagam, M.D Pediatrics Medicare: Medicare Enrolled Practice Location: 2112 Sw H K Dodgen Loop Ste 110, Temple, TX 76504 Phone: 877-800-5722 | |
Dr. Madhava Reddy Beeram, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1901 Sw H K Dodgen Loop, Temple, TX 76502 Phone: 254-935-4000 | |
Dr. Michael C. Smith, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2401 S 31st St, Temple, TX 76508 Phone: 254-724-2111 | |
Edwin Hernandez Caro, Pediatrics Medicare: Medicare Enrolled Practice Location: 1901 Sw H K Dodgen Loop Bldg 300, Temple, TX 76502 Phone: 254-724-5437 | |
Dr. Alisa Ana Acosta, MD, MPH Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 2401 S 31st St, Temple, TX 76508 Phone: 254-724-2111 | |
Dr. Holly Mead Fatter, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2401 S 31st St, Temple, TX 76508 Phone: 254-724-5092 | |
Parneet Dhaliwal, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2401 South 31st Street, Ms-ck 300, Temple, TX 76508 Phone: 254-935-5063 |