Healthcare Provider Details

I. General information

NPI: 1700171014
Provider Name (Legal Business Name): BONNY OGAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2011
Last Update Date: 06/19/2024
Certification Date: 06/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4316 FEAGAN ST UNIT B
HOUSTON TX
77007-5718
US

IV. Provider business mailing address

4316 FEAGAN ST UNIT B
HOUSTON TX
77007-5718
US

V. Phone/Fax

Practice location:
  • Phone: 301-379-9682
  • Fax:
Mailing address:
  • Phone: 301-379-9682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberQO526
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberQ0526
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: