MEDICARE: MARLAINA G BONNES NEUMANN MD

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
1	207R00000X	Internal Medicine Physician	L5993	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8M5234	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1679503395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLAINA G BONNES NEUMANN MD

Provider Business Mailing Address
First Line	:	8000 RESEARCH FOREST DR
Second Line	:	360
City	:	THE WOODLANDS
State	:	TX
Zip	:	77382-1504
Country	:	US
Telephone Number	:	281-292-1191
Fax Number	:	281-362-9170

Provider Business Practice Location Address
First Line	:	8000 RESEARCH FOREST DR
Second Line	:	360
City	:	THE WOODLANDS
State	:	TX
Zip	:	77382-1504
Country	:	US
Telephone Number	:	281-292-1191
Fax Number	:	281-362-9170

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	05/15/2012

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