Provider Demographics
NPI:1194963215
Name:BONSU, AUGUSTINA B (NP)
Entity type:Individual
Prefix:MRS
First Name:AUGUSTINA
Middle Name:B
Last Name:BONSU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:850 CENTRAL PKWY E
Mailing Address - Street 2:SUITE 275
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-5561
Mailing Address - Country:US
Mailing Address - Phone:972-881-4688
Mailing Address - Fax:972-881-4609
Practice Address - Street 1:850 CENTRAL PKWY E
Practice Address - Street 2:SUITE 275
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-5561
Practice Address - Country:US
Practice Address - Phone:972-881-4688
Practice Address - Fax:972-881-4609
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-27
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXA0808392363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX318353YNVLOtherMEDICARE IND
TX2035487-01OtherGROUP TPI
TX00115XOtherMEDICARE GROUP
TX8916NDOtherBCBS