Matt Bonander LLC

Organization Active NPI Physical Therapist · Krum, TX

NPI 1154074201 · NPPES record last updated Oct 1, 2024

Key facts

NPI
1154074201
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 225100000X
Legal business name
MATT BONANDER LLC
Practice address
4118 Herdsman Dr
Krum, TX 76249-1556
Phone
(940) 535-8105
NPI assigned
Jan 29, 2022
Organization subpart
No

Authorized official

Name
Dr. Matthew Ellis Bonander, PT, DPT
Title
Physical Therapist
Phone
(940) 535-8105

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20220315001306 TX Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3274928023 Receives reassigned benefits from 14 practitioners
Practice locations: Krum, TX; Little Elm, TX

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225100000X Yes
Occupational Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225X00000X

Addresses

Primary practice location

4118 Herdsman Dr
Krum, TX 76249-1556

Mailing address

4118 Herdsman Dr
Krum, TX 76249-1556
Phone (940) 535-8105

Other providers in Krum, TX

All providers in Krum, TX · Physical Therapist in Texas

Sources for this page

Verify at the official NPI Registry.