Basic Information
Provider Information
NPI: 1801394093
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BONTON
FirstName: APRIL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MS CCC-SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 305 NE LOOP 820
Address2: BUSINESS TOWER 1, SUITE 200
City: HURST
State: TX
PostalCode: 76053
CountryCode: US
TelephoneNumber: 8172928787
FaxNumber: 8177896849
Practice Location
Address1: 9330 BROADWAY ST STE 312
Address2:  
City: PEARLAND
State: TX
PostalCode: 775847895
CountryCode: US
TelephoneNumber: 8328566241
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/23/2018
LastUpdateDate: 01/23/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X112878TXY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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