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General NPI Number Information
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NPI Number | 1962506386
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Entity Type | Organization
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Legal Business Name | TEXAS ENDOSURGERY ASSOCIATES
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Dates
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Enumeration Date | 09/08/2006
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Last Update Date | 01/13/2010
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Provider Practice Location Address
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Address Line | 21720 KINGSLAND BOULEVARD, SUITE 303A
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City | KATY
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State | TX
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Zip | 77450
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Country | US
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Telephone | 281-579-5638
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Fax | 281-579-5636
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Provider Business Mailing Address
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Address Line | 21720 KINGSLAND BOULEVARD, SUITE 303A
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City | KATY
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State | TX
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Zip | 77450
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Country | US
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Telephone | 281-579-5638
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Fax | 281-579-5636
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Authorized Official
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Title or Position | MD
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Name | DR. RICARDO M BONNOR
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Credential | MD
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Telephone | 281-579-5638
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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