MEDICARE: DR. BONNY OGAR M.D.

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	QO526	TX
2	207R00000X	Internal Medicine Physician	Q0526	TX

General Provider Information

NPI Number	:	1700171014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BONNY OGAR M.D.

Provider Business Mailing Address
First Line	:	4316 FEAGAN ST UNIT B
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-5718
Country	:	US
Telephone Number	:	301-379-9682
Fax Number	:

Provider Business Practice Location Address
First Line	:	4316 FEAGAN ST UNIT B
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-5718
Country	:	US
Telephone Number	:	301-379-9682
Fax Number	:

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

Provider Enumeration Date	:	06/15/2011
Last Update Date	:	06/19/2024

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