Individual
BONNIE AHRENS WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1651 W ROSEDALE ST STE 100, FORT WORTH, TX 76104-7437
(817) 930-2030
Mailing address
1651 W ROSEDALE ST STE 100, FORT WORTH, TX 76104-7437
(817) 930-2030
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA02950
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187161801
—
TX
01
—
P00404027
RAILROAD MEDICARE
—
Enumeration date
07/07/2006
Last updated
08/03/2023
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