Individual
DR. RICHARD B. BONNER
Active
Individual
DR. RICHARD B. BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
J8468
TX
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
J8468
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1117681-04
—
TX
01
—
1117681-06
CSHCN
TX
01
—
8J5012
BLUE SHIELD
TX
01
—
P00036792
RR/MEDICARE
TX
Enumeration date
03/23/2006
Last updated
12/03/2021
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