# DHHS IHS PHOENIX AREA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bylas Health Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790038743
- **Authorized official:** MRS. SHIRLEY M BONI (ADMINISTRATIVE OFFICER)
- **Authorized official phone:** (928) 475-7348

## Contact information

- **Practice address:** HIGHWAY 70, MP 295.6, BYLAS, AZ 85530
- **Practice address phone:** (928) 475-2686
- **Mailing address:** PO BOX 149, BYLAS, AZ 85530-0149
- **Mailing address phone:** (928) 475-2686

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | — |
| 122300000X | Dentist | — | — | — |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 10/16/2012
- **Last updated:** 10/16/2012