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BONNY BENJAMIN PETTY PA-C
NPI 1194094961
Physician Assistant in Round Rock, TX

Active since December 22, 2011
3001 JOE DIMAGGIO BLVD STE 900B, ROUND ROCK, TX 78665(512) 729-1800 Get Directions Write a Review

NPPES record last updated: January 29, 2025. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Nov 12, 2024, Oct 28, 2016 (2 updates tracked since 2016).

About Bonny Benjamin Petty Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BONNY BENJAMIN PETTY PA-C (NPI 1194094961) is an individual physician assistant in Round Rock, Texas, licensed in Texas (PA07479) and active in the NPI registry since December 2011.

NPPES Registry Identity

NPI1194094961
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameBONNY BENJAMIN PETTYCredential: PA-C
Location Address3001 JOE DIMAGGIO BLVD STE 900BRound Rock, TX 78665-3976
Mailing Address1508 Crockett Gardens Rd # 200Georgetown, TX 78628-4033 · (512) 585-8468 · Fax (512) 610-0392
Phone(512) 729-1800
Sole ProprietorNo
Enumeration DateDecember 22, 2011
Last NPPES UpdateJanuary 29, 20252 updates tracked since enumeration
NPPES CertifiedJanuary 29, 2025
✔ NPI 1194094961 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in TX · PA07479
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
3001 JOE DIMAGGIO BLVD STE 900B, Round Rock, TX 78665
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELEVATE METAL HEALTH PLLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
3001 JOE DIMAGGIO BLVD STE 900B
ROUND ROCK, TX 78665
Williamson County (512) 729-1800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bonny Petty's NPI number?

The NPI number for Bonny Petty is 1194094961. It was assigned to this individual provider in the NPPES registry on December 22, 2011.

Where is Bonny Petty located?

Bonny Petty practices at 3001 Joe Dimaggio Blvd Ste 900B, Round Rock, TX 78665. The listed phone number is (512) 729-1800.

What is Bonny Petty's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

What insurance does Bonny Petty accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 5 other insurers list Bonny Petty as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Bonny Petty was last updated on January 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.