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General NPI Number Information
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NPI Number | 1790019271
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Entity Type | Individual
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Provider Name | BONITA THIBAULT BORGER APRN
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Gender | Female
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Dates
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Enumeration Date | 09/30/2009
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 1221 W BEN WHITE BLVD STE 200B
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City | AUSTIN
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State | TX
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Zip | 78704-7002
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Country | US
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Telephone | 877-800-5722
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Fax |
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Provider Business Mailing Address
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Address Line | 2423 WILLIAMS DR STE 107
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City | GEORGETOWN
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State | TX
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Zip | 78628-3269
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Country | US
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Telephone | 877-800-5722
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 89081
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041-354024
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 004225
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209008456
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP126248
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 855718
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License Number State | TX
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