Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 036.101170 | IL |
Y | 207P00000X | Emergency Physician | L7984 | TX |
N | 207Q00000X | Family Doctor | L7984 | TX |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | L7984 | TX |
NPI | 1386623353 |
---|---|
Provider Name | Michael M Bond |
First Address | Plano, TX 75093-8120 |
Second Address | Greenville, IL 62246-1154 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2006 |
Last Update Date | 10/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H16267 | (02) | TX |