Provider Demographics
NPI:1871572123
Name:BONAR, JAMES PETER (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PETER
Last Name:BONAR
Suffix:
Gender:M
Credentials:MD
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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:713-295-6169
Practice Address - Street 1:500 MEDICAL CENTER BLVD
Practice Address - Street 2:STE 100
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2800
Practice Address - Country:US
Practice Address - Phone:936-788-8084
Practice Address - Fax:936-788-8054
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL 00362083P0011X, 2086S0102X
TXL0036208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX183436802Medicaid
MDH02391Medicare UPIN
TX183436802Medicaid