Individual
THERONICA ROOSETTA BOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3200 MATLOCK RD, ARLINGTON, TX 76015
(817) 468-4000
(817) 284-3425
Mailing address
P O BOX 678625, DALLAS, TX 75267-8625
(817) 284-9850
(817) 284-3425
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
M7865
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8AW000
BLUECROSS BLUESHIELD OF TEXAS
TX
01
—
BP3-0018732
INSTITUTIONAL PERMIT
—
Enumeration date
06/11/2007
Last updated
07/27/2018
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