Juan Alfredo Bonilla
Pediatric Otolaryngology
16723 Huebner Rd
San Antonio
, Texas 78248-2342
Juan Alfredo Bonilla
Pediatric Otolaryngology
16723 Huebner Rd
San Antonio
, Texas 78248-2342
(210) 402-3417
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About
Features
Specialties
- Pediatric Otolaryngology
Languages spoken
- English
Location
First Address
- Juan Alfredo Bonilla
- Po Box 29749
- San Antonio, TX
- Zip : 78229-0749
- Fax : (210) 402-3417
- Phone : (210) 733-4368
Second Address
- Juan Alfredo Bonilla
- 16723 Huebner Rd
- San Antonio, TX
- Zip : 78248-2342
- Fax : (210) 402-3417
- Phone : (210) 733-4368
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207YP0228X | Pediatric Otolaryngology | G4841 | TX |
National Provider Identifier
| NPI | 1548260078 |
|---|---|
| Provider Name | Juan Alfredo Bonilla |
| First Address | San Antonio, TX 78229-0749 |
| Second Address | San Antonio, TX 78248-2342 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/07/2005 |
| Last Update Date | 31/05/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 095065103 | (05) | TX |
| 120180801 | (05) | TX |
| 120180805 | (05) | TX |
| B74984 | (02) | |
| BB1396200 | DEA (01) | |
| F0072234 | DPS (01) | |
| G4841 | STATE LIC (01) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.