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NPI Code Detail

MEDICARE: BONNIE THOMSON FNP

MEDICARE: BONNIE THOMSON FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner1168769TX

General Provider Information

NPI Number : 1013754571
Entity Type Code : Individual
Provider Name (Legal Business Name) : BONNIE THOMSON FNP
Provider Business Mailing Address
First Line : 13005 TITUS CT
Second Line :
City : AUSTIN
State : TX
Zip : 78732-2164
Country : US
Telephone Number : 512-633-7754
Fax Number :
Provider Business Practice Location Address
First Line : 3620 E WHITESTONE BLVD
Second Line :
City : CEDAR PARK
State : TX
Zip : 78613-7441
Country : US
Telephone Number : 512-260-2732
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2024
Last Update Date : 07/19/2024

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