Individual
WILLIAM F BONNELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 7TH AVE, FORT WORTH, TX 76104-2733
(682) 885-6800
(817) 885-2106
Mailing address
PO BOX 99213, FORT WORTH, TX 76199-0213
(682) 885-1855
(682) 885-7347
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
L6295
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00L42V
MEDICARE GROUP
TX
01
—
137283112
MEDICAID GROUP
TX
01
—
137283113
CSHCN GROUP
TX
01
—
161783905
CSHCN
TX
05
—
161783906
—
TX
01
—
1669442042
GRP NPI NUMBER
—
Enumeration date
08/12/2006
Last updated
04/13/2010
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