Jeremy Bonilla

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

44728673 Issued in TX

Practice address

1508 W Avenue J
Temple, TX 76504-5390

Phone

(254) 771-3374

NPI assigned

Sep 18, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Temple Community Clinic

  • Community Health Clinic/Center
  • Temple, TX
  • NPI 1720922651
  NPD (past)

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

{
    "created_epoch": "1758153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758153600000",
    "number": "1982576039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10910 LITTLE GAP CT",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774980946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 W AVENUE J",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765045390",
            "telephone_number": "254-771-3374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "JEREMY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-18",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "44728673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yousif Bolus, DMD
• Maalini Bommakanti
• Melissa Bonano
• Michelle Lynne Bond, MSN-NNP
• William Kirkland Bond, D.D.S.
• Aleta Bonner, M.D.
• Richard B. Bonner, M.D.
• David Christopher Booker Jr., MD
• Jennifer Boone, LVN
• Robert Thomas Booth, M.D.

• Student in an Organized Health Care Education/Training Program in Temple, TX
• Providers in Temple, TX by specialty
• Student in an Organized Health Care Education/Training Program in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.