Healthcare Provider Details

I. General information

NPI: 1164741674
Provider Name (Legal Business Name): BONNIE HONG HAYASHI M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2010
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1904 PINE ST STE 200
ABILENE TX
79601-2450
US

IV. Provider business mailing address

1904 PINE ST STE 200
ABILENE TX
79601-2450
US

V. Phone/Fax

Practice location:
  • Phone: 325-670-5570
  • Fax: 833-437-1267
Mailing address:
  • Phone: 325-670-5570
  • Fax: 833-437-1267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberP8786
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: