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General NPI Number Information
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NPI Number | 1134392863
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Entity Type | Organization
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Legal Business Name | BONNY S. OLNEY, D.O., P.A.
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Dates
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Enumeration Date | 04/02/2008
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Last Update Date | 04/02/2008
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Provider Practice Location Address
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Address Line | 18333 PRESTON RD SUITE #550
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City | DALLAS
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State | TX
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Zip | 75252-5466
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Country | US
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Telephone | 972-735-7900
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Fax | 972-735-7902
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Provider Business Mailing Address
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Address Line | 18352 DALLAS PKWY #136-458
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City | DALLAS
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State | TX
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Zip | 75287-5227
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Country | US
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Telephone | 972-735-7900
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Fax | 972-735-7902
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. BONNY S. OLNEY
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Credential | D.O.
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Telephone | 972-735-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | J6638
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License Number State | TX
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