Provider Demographics
NPI:1992763270
Name:BONNOR, RICARDO M (MD)
Entity type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:M
Last Name:BONNOR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:18211 KATY FWY STE 250
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77094-1398
Mailing Address - Country:US
Mailing Address - Phone:281-579-5638
Mailing Address - Fax:281-579-5636
Practice Address - Street 1:18211 KATY FWY STE 250
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77094-1398
Practice Address - Country:US
Practice Address - Phone:281-579-5638
Practice Address - Fax:281-579-5636
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2020-01-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXL5679208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7450629OtherAETNA
TX4154816OtherCIGNA
TXP00427347OtherRAILROAD MEDICARE
TX8W5120OtherBLUE CROSS BLUE SHIELD
TX4154816OtherCIGNA
TXI14102Medicare UPIN