Most Relevant Information
Provider Data
| NPI Number: | 1003650607 |
| Provider Name: | DAVID BRADLEY BONHAM CNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 1167246 |
Most Important Dates
| Enumeration Date: | 06/19/2024 |
| Last Updated: | 06/19/2024 |
Provider Practice Location
2501 JIMMY JOHNSON BLVD STE 110
PORT ARTHUR
TX
776402011
Practice Location Phone/Fax
| Phone: | 4093444466 |
| Fax: |
Provider Mailing Location
8849 PINEWOOD DR APT 8203
PORT ARTHUR
TX
776401185
Provider Mailing Phone/Fax
| Phone: | 8327442375 |
| Fax: |