Individual provider · NPI-1

Derek C Bonn, NP

Nurse Practitioner · League City, TX

NPI number1720555097
StatusActive
Last updated in NPPESApr 30, 2021

Details

NPI
1720555097
Entity type
Individual (NPI-1)
Name
Derek C Bonn
Credential
NP
Sex
Male
Sole proprietor
No
Enumeration date
Oct 25, 2018
Certification date
Apr 30, 2021
Last updated
Apr 30, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363L00000X Nurse PractitionerAP139481TXYes
363LF0000X Nurse Practitioner, FamilyAP139481TX

Practice location

2560 E League City Pkwy
League City, TX 77573-6459

Phone 281-783-8162 · Fax 713-439-7995

Mailing address

16107 Kensington Dr Ste 126
Sugar Land, TX 77479-4224

Phone 281-336-0552 · Fax 281-336-0552

Other practice locations

1111 W Adoue St
Alvin, TX 77511-2718

Phone 281-824-1480 · Fax 281-220-6407

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Nurse Practitioner providers in League City, TX