Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | N4472 | TX |
NPI | 1033232418 |
---|---|
Provider Name | Dr. Bernard August Hildebrand JR. |
First Address | San Antonio, TX 78220-1013 |
Second Address | San Antonio, TX 78220-1013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2007 |
Last Update Date | 19/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
369914201 | (05) | TX |