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NPI Code Detail

MEDICARE: DANA M BOND NP

MEDICARE: DANA M BOND NP
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
1363LP0200XPediatric Nurse Practitioner579874TX
2363LP0200XPediatric Nurse PractitionerAP104242TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18N7541OTHERTXBCBS

General Provider Information

NPI Number : 1770573842
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANA M BOND NP
Provider Business Mailing Address
First Line : PO BOX 99371
Second Line :
City : FORT WORTH
State : TX
Zip : 76199-0371
Country : US
Telephone Number : 682-885-1855
Fax Number : 682-885-4734
Provider Business Practice Location Address
First Line : 1500 COOPER ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-2710
Country : US
Telephone Number : 682-885-4405
Fax Number : 682-885-4407
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2005
Last Update Date : 11/26/2019

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