DR. RICHARD B. BONNER (NPI# 1659331841) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659331841 |
| Entity Type | Individual |
| Full Name | DR. RICHARD B. BONNER |
| Credential | M.D. |
| Practice Address |
1901 Sw H K Dodgen Loop Temple TX 76502-1814 |
| Mailing Address |
Po Box 844658 Dallas TX 75284-4658 |
| Practice Telephone | 2549354000 |
| Mailing Telephone | 8009940371 |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2019-05-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | J8468 | TX | Allopathic & Osteopathic Physicians |
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
J8468 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | RR/MEDICARE | P00036792 | 01 |
| TX | CSHCN | 1117681-06 | 01 |
| TX | 1117681-04 | 05 | |
| TX | BLUE SHIELD | 8J5012 | 01 |
| Street Address |
1901 SW H K DODGEN LOOP |
| City | TEMPLE |
| State | TX |
| Zip Code | 76502-1814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982681177 | Robin Ann Weerts | Nurse Anesthetist, Certified Registered | 1901 Sw H K Dodgen Loop, Temple, TX 76502 | 2005-12-28 |
| 1205458296 | Connor Travis Larson | Nurse Anesthetist, Certified Registered | 1901 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2020-05-12 |
| 1285277061 | Charity Ann Driver | Nurse Practitioner | 1901 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2019-10-23 |
| 1780232223 | Ahmed Gamal Aquino | Counselor | 1901 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2019-08-28 |
| 1629620778 | Cristiane Rocha Krohn | Registered Nurse | 1901 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2019-07-09 |
| 1801356159 | Daniel Dvoskin | Student in an Organized Health Care Education/Training Program | 1901 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2019-03-22 |
| 1720546039 | Irma Valle | Nurse Anesthetist, Certified Registered | 1901 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2019-03-05 |
| 1316411200 | Jadon Kirven | Counselor | 1901 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2019-01-14 |
| 1801371414 | Chad Krumpholz | Physician Assistant | 1901 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2018-09-28 |
| 1629550983 | Hailey Marek | Occupational Therapist | 1901 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2018-09-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033710850 | Bih Mobanoe Chi | Pharmacist | 6801 West Adams Avenue, Temple, TX 76502 | 2020-11-06 |
| 1639705403 | Robert David Pompella | Chiropractor | 4805 Stone Ridge Dr, Temple, TX 76502 | 2020-03-12 |
| 1275167488 | Luong Dental, LLC | Dentist | 5297 S. 31st Street, Ste 111, Temple, TX 76502 | 2020-02-26 |
| 1093357931 | Ryan T Stephens Dmd Pllc | Dentist | 5408 W. Adams Suite 102, Temple, TX 76502 | 2019-10-11 |
| 1164071817 | Danyelle Denise Pividori | Licensed Vocational Nurse | 992 Marlandwood Rd, Temple, TX 76502 | 2019-09-05 |
| 1831670652 | Jane Lida Jarosz | Registered Nurse | 99 Marlandwood, Temple, TX 76502 | 2018-08-29 |
| 1043791809 | Elsa Gamban Baker | Licensed Practical Nurse | 5711 Hopkins Dr, Temple, TX 76502 | 2018-08-28 |
| 1659859288 | Laura Bright | Licensed Vocational Nurse | 990 Marlanwood, Temple, TX 76502 | 2018-08-06 |
| 1811489974 | Rockdale Blackhawk, LLC | Clinic/Center | 1909 Sw Hk Dodgen Loop, Temple, TX 76502 | 2018-06-05 |
| 1871094573 | Moc Temple, LLC | Skilled Nursing Facility | 725 Marlandwood Rd., Temple, TX 76502 | 2018-02-27 |
| Find all providers in zip 76502 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306172945 | Omar S Arrieta | Pediatrics | Scott & White 4 South Pedi Administration Rm 431, 2401 South 31st Street, Temple, TX 76508-0001 | 2009-11-01 |
| 1194995506 | Dinesh Singh | Pediatrics | 1901 Sw H K Dodgen Loop Bldg 300, Temple, TX 76502-1814 | 2008-03-03 |
| 1861515843 | Manish Anilkumar Desai | Pediatrics | 2401 S 31st St, Temple, TX 76508-0001 | 2007-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093294654 | Elva Linda Pereida | Pediatrics | 107 Palisades, Portland, TX 78374-4144 | 2018-08-14 |
| 1083156905 | Pediatric Immediate Care of Texas, Pllc | Pediatrics | 3831 E League City Pkwy, Suite A, League City, TX 77573-7155 | 2016-11-09 |
| 1053730226 | Jaime Conrado Silva | Pediatrics | 1911 Holcombe Blvd Apt 1326, Houston, TX 77030-4189 | 2014-04-15 |
| 1144574591 | Amy Sharon Arrington | Pediatrics | 6621 Fannin, W6006, Houston, TX 77030 | 2012-11-07 |
| 1306118013 | Corey Chartan | Pediatrics | One Baylor Plaza, Mail Stop W6-006, Pediatric Critical Care, Houston, TX 77070 | 2012-01-27 |
| 1396971206 | Kevin Matthew Roy | Pediatrics | 6621 Fannin Street, Wt6-006, Texas Children's Hospital, Pediatrics Intensive Care, Houston, TX 77030 | 2009-06-05 |
| 1609036342 | Loay Y Abdulsamad | Pediatrics | 11322 Bucks Bridge Ln, Sugar Land, TX 77478-0915 | 2008-06-16 |
| 1396911715 | Aarti C Bavare | Pediatrics | 6621 Fannin, Wt6-006, Houston, TX 77030 | 2008-05-06 |
| 1982726741 | Terry Lee Furgiuele | Pediatrics | 4600 Ashville Pl, Amarillo, TX 79119-6452 | 2007-04-04 |
| 1225106875 | Childrens Critical Care of San Antonio Pa | Pediatrics | 5925 Kirby Dr, E354, Houston, TX 77005-2546 | 2006-12-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.