Norman Bondesen

Individual provider Active NPI Pharmacist · Alto, TX

NPI 1962009555 · NPPES record last updated Oct 6, 2020

Key facts

NPI
1962009555
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
25269 (TX)
Practice address
272 North Marcus
Alto, TX 75925
Phone
(936) 858-4311
Fax
(936) 858-3865
NPI assigned
Oct 6, 2020
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
25269TXMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Brookshire Brothers Inc Past
since Oct 11, 2020
Accepting new patients
Brookshire Brothers Inc Past
since Oct 11, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 25269 TX Yes

Addresses

Primary practice location

272 North Marcus
Alto, TX 75925

Mailing address

706 Crooked Creek Dr
Nacogdoches, TX 75965-1925
Phone (936) 559-3441

Other providers in Alto, TX

All providers in Alto, TX · Pharmacist in Texas

Sources for this page

Verify at the official NPI Registry.