MEDICARE: DR. BONNIE BAIRD FURNER 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	207N00000X	Dermatology Physician	G4803	TX

General Provider Information

NPI Number	:	1871561910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BONNIE BAIRD FURNER MD

Provider Business Mailing Address
First Line	:	8122 DATAPOINT DR
Second Line	:	SUITE 1110
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3272
Country	:	US
Telephone Number	:	210-616-0448
Fax Number	:	210-614-1241

Provider Business Practice Location Address
First Line	:	8122 DATAPOINT DR
Second Line	:	SUITE 1110
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3272
Country	:	US
Telephone Number	:	210-616-0448
Fax Number	:	210-614-1241

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

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	07/08/2007

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