Provider Demographics
NPI:1699967737
Name:BON MED HYPERBARIC AND WOUND CARE ASSOCIATES PA
Entity type:Organization
Organization Name:BON MED HYPERBARIC AND WOUND CARE ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:BONAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-471-8113
Mailing Address - Street 1:5099 CEDAR CREEK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-2401
Mailing Address - Country:US
Mailing Address - Phone:713-471-8113
Mailing Address - Fax:
Practice Address - Street 1:7600 BEECHNUT ST
Practice Address - Street 2:MEMORIAL HERMANN HYPERBARIC AND WOUND CARE CENTER
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-4302
Practice Address - Country:US
Practice Address - Phone:713-471-8113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL 00362083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Y884OtherMEDICARE PTAN