Healthcare Provider Details

I. General information

NPI: 1619355336
Provider Name (Legal Business Name): KATHRYN ELIZABETH BOND D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2015
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 W WHEATLAND RD
DALLAS TX
75237
US

IV. Provider business mailing address

20745 N SCOTTSDALE RD
SCOTTSDALE AZ
85255-6453
US

V. Phone/Fax

Practice location:
  • Phone: 214-947-5400
  • Fax: 214-947-5476
Mailing address:
  • Phone: 480-882-7500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR5515
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberBP10054191
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: