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NPI Code Detail

MEDICARE: RACHEL BONNEMA MD

MEDICARE:   RACHEL  BONNEMA  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician24674NE
2207R00000XInternal Medicine PhysicianMD428215PA
3207R00000XInternal Medicine PhysicianR8160TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1R8160OTHERTXTEXAS MEDICAL LICENSE

General Provider Information

NPI Number : 1861540551
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHEL BONNEMA MD
Provider Business Mailing Address
First Line : P.O. BOX 845347
Second Line :
City : DALLAS
State : TX
Zip : 75284-7208
Country : US
Telephone Number : 214-648-2992
Fax Number : 214-648-3700
Provider Business Practice Location Address
First Line : 5959 HARRY HINES BLVD.
Second Line : MAIL CODE 9126
City : DALLAS
State : TX
Zip : 75390
Country : US
Telephone Number : 214-648-2992
Fax Number : 214-648-3700
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2007
Last Update Date : 11/26/2018

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Directions to “ RACHEL BONNEMA MD” Practice Location

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