MEDICARE: DR. FRANK P. BONIKOWSKI M.D.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	H2098	TX
2	2084B0040X	Behavioral Neurology & Neuropsychiatry Physician	H2098	TX
3	2084N0600X	Clinical Neurophysiology Physician	H2098	TX
4	2084D0003X	Diagnostic Neuroimaging (Psychiatry & Neurology) Physician	H2098	TX
5	2084N0008X	Neuromuscular Medicine (Psychiatry & Neurology) Physician	H2098	TX
6	2084P2900X	Pain Medicine (Psychiatry & Neurology) Physician	H2098	TX
7	2084S0012X	Sleep Medicine (Psychiatry & Neurology) Physician	H2098	TX
8	2084N0400X	Neurology Physician	H2098	TX

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	130013606	OTHER	TX	RAILROAD MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	812594	OTHER	TX	BCBS

NPI Number	:	1700870508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANK P. BONIKOWSKI M.D.

Provider Business Mailing Address
First Line	:	1521 S STAPLES ST
Second Line	:	SUITE 402
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78404-3150
Country	:	US
Telephone Number	:	361-883-1731
Fax Number	:	361-883-1440

Provider Business Practice Location Address
First Line	:	1521 S STAPLES ST
Second Line	:	STE. 402
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78404-3150
Country	:	US
Telephone Number	:	361-883-1731
Fax Number	:	361-883-1440

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

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	01/15/2013