Mario A. Bonilla, M.D

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

F5839 Issued in TX

Practice address

5026 Pool Road
Denison, TX 75020-4595

Phone

(903) 465-3624

Fax

(903) 465-3973

NPI assigned

Jul 5, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Texomacare

  • Family Medicine Physician
  • Denison, TX
  • NPI 1740233592

  Internal Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516924800000",
    "number": "1609873736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5012 S US HIGHWAY 75 STE 300",
            "address_2": "ATTN BILLING",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750204589",
            "telephone_number": "903-465-3624",
            "fax_number": "903-465-3973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5026 POOL ROAD",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750204595",
            "telephone_number": "903-465-3624",
            "fax_number": "903-465-3973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "MARIO",
        "middle_name": "A.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2018-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "F5839",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "F5839",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "F5839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "12480",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100041710A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132567208",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Marsden Blanch, M.D.
• Micah Leigh Blevins-Rudd
• Blissful Hospice and Palliative Care LLC
• Carrie Boettger, LPC
• Curtis Duane Bogard, D.D.S.
• Boyd Physical Therapy PLLC
• Shannon Taylor Boyd, P.T.
• Elizabeth Anne Boyer, LOT
• Courtney Catherine Bramhall, DC
• Sarah Branam, D.O.

• Interventional Cardiology Physician in Denison, TX
• Providers in Denison, TX by specialty
• Interventional Cardiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.