BONNY SU WONG (NPI# 1316326366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316326366 |
| Entity Type | Individual |
| Full Name | BONNY SU WONG |
| Credential | M.D. |
| Practice Address |
3000 N Ih 35 Ste 660 Austin TX 78705-1851 |
| Practice Telephone | 5122361310 |
| Mailing Telephone | 5122361310 |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2020-10-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208100000X | Physical Medicine & Rehabilitation | BP20056781 | TX | Allopathic & Osteopathic Physicians |
| Y | 2081P0301X |
Physical Medicine & Rehabilitation Specialization: Brain Injury Medicine |
S6329 | TX | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 55 Fruit St, Boston, MA 021142696 | 6177262000 | |
| 7200 Cambridge St, Houston, TX 770304202 | 7137981000 |
| Street Address |
3000 N IH 35 STE 660 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78705-1851 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841269263 | Juan M. Latorre | Physical Medicine & Rehabilitation | 3000 N Ih 35 Ste 660, Austin, TX 78705-1851 | 2006-03-16 |
| 1013163146 | Robert Lee | Physical Medicine & Rehabilitation | 3000 N Ih 35 Ste 660, Austin, TX 78705-1851 | 2008-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740894559 | Ben Aviel | Specialist/Technologist | 2501 Leon, Austin, TX 78705 | 2020-08-31 |
| 1700408739 | Julie Marie Dorland | Obstetrics & Gynecology | Ut Austin Dell Medical School Obgyn Medical Park Tower, 1301 W 38th St, Suite 705, Austin, TX 78705 | 2020-05-13 |
| 1952941155 | Oluwakemi Yemi-ese | Counselor | 2717 Rio Grande Street, Austin, TX 78705 | 2020-01-15 |
| 1285272765 | Lisa K Wheeler | Counselor | 2520 Longivew Street, Suite 313, Austin, TX 78705 | 2019-12-16 |
| 1033767637 | Olivia May Neel | Specialist/Technologist | 620 West 24th Street, 208a, Austin, TX 78705 | 2019-08-28 |
| 1336795202 | Grace Evelyn Martin | Specialist/Technologist | University of Texas, 110 Inner Campus Drive, Austin, TX 78705 | 2019-08-15 |
| 1801450317 | Nicole Buchele | Obstetrics & Gynecology | Ut Austin Dell Medical School-obgyn, Medical Park Tower, 1301 W 38th St, Suite 705, Austin, TX 78705 | 2019-04-30 |
| 1124502794 | Joan Margaret Carroll | Physician Assistant | 3000 N, I-35, Suite 600, Austin, TX 78705 | 2018-09-19 |
| 1841797636 | Corbin Anne Weaver | Obstetrics & Gynecology | Medical Park Tower, 1301 W. 38th St., Suite 705, Austin, TX 78705 | 2018-04-09 |
| 1740707892 | Christine Marie Falk | Specialist/Technologist | 2810 Hemphill Park, Apt 211, Austin, TX 78705 | 2017-08-29 |
| Find all providers in zip 78705 | ||||
| Taxonomy Code | 2081P0301X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Brain Injury Medicine |
| A Brain Injury Medicine physician specializes in disorders of brain function due to injury and disease. These disorders encompass a range of medical, physical, neurologic, cognitive, sensory, and behavioral disorders that result in psychosocial, educational, and vocational consequences. |
| Notes: Source: American Board of Physical Medicine and Rehabilitation, 2015. www.abpmr.org [1/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033551965 | Savitha Bonthala | Physical Medicine & Rehabilitation | 1300 Binz St Fl 3, Houston, TX 77004-7016 | 2013-07-19 |
| 1760826028 | Peter Riedel | Physical Medicine & Rehabilitation | 9180 Pinecroft Dr Ste 420, Shenandoah, TX 77380-3880 | 2013-04-17 |
| 1043828817 | Texas Brain Center, LLC | Physical Medicine & Rehabilitation | 4200 Twelve Oaks Dr, Houston, TX 77027-6812 | 2020-07-17 |
| 1710369129 | Jean Woo | Physical Medicine & Rehabilitation | 7200 Cambridge St, Houston, TX 77030-4202 | 2015-06-22 |
| 1356515654 | Foluke Adeola Akinyemi | Physical Medicine & Rehabilitation | 2201 Se Loop 820, Fort Worth, TX 76119 | 2008-04-17 |
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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.