Individual
BONNY SU WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 726-2000
Mailing address
3000 N IH 35 STE 660, AUSTIN, TX 78705-1851
(512) 236-1310
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
BP20056781
TX
2081P0301X
Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
Primary
S6329
TX
Other
Enumeration date
05/22/2015
Last updated
01/04/2022
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