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General NPI Number Information
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NPI Number | 1659792091
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Entity Type | Organization
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Legal Business Name | WILLIAM W BONDURANT III, M.D., P.A.
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Dates
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Enumeration Date | 01/03/2014
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Last Update Date | 01/03/2014
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Provider Practice Location Address
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Address Line | 6801 EMMETT F LOWRY EXPY
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City | TEXAS CITY
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State | TX
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Zip | 77591-2500
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Country | US
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Telephone | 409-739-3238
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Fax |
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Provider Business Mailing Address
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Address Line | 7 COLONY PARK CIR
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City | GALVESTON
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State | TX
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Zip | 77551-1737
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Country | US
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Telephone | 409-739-3238
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILLIAM W BONDURANT III
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Credential | M.D.
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Telephone | 409-739-3238
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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