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Organization
BONSAI MEDICAL LLC
Active
Organization
BONSAI MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER J BENNETT (OWNER)
(281) 547-0706
Entity
Organization
Contact information
Practice address
3900 N CAUSEWAY BLVD STE 1470, METAIRIE, LA 70002-7253
(281) 930-5182
Mailing address
6232 N HIGHWAY 146, BAYTOWN, TX 77523-1000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
293D00000X
Physiological Laboratory
Primary
—
—
Other
Enumeration date
09/26/2017
Last updated
01/22/2018
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