Individual
DR. ALETA BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
Mailing address
PO BOX 840003, DALLAS, TX 75284-0003
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
J8716
TX
208000000X
Pediatrics Physician
J8716
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0921686-03
—
TX
01
—
0921686-04
CSHCN
TX
01
—
8J5013
BLUE SHIELD
TX
01
—
P00036786
RR/MEDICARE
TX
Enumeration date
03/23/2006
Last updated
12/03/2021
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