Bonilla, Juan Alfredo

Bonilla, Juan Alfredo is an individual health care provider with primary practice located at 16723 Huebner Rd , San Antonio TX 78248-2342. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Pediatric Otolaryngology. Allopathic & Osteopathic Physicians / Pediatric Otolaryngology is his primary health care specialty. Bonilla, Juan Alfredo can be contacted via phone (210) 733-4368.

Contact Information

Primary practice address
16723 Huebner Rd San Antonio TX 78248-2342
Phone: (210) 733-4368
Fax: (210) 402-3417
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X G4841 Texas
Allopathic & Osteopathic Physicians / Pediatric Otolaryngology 207YP0228X G4841 Texas

Profile Details

NPI number 1548260078
LBN Legal business name Bonilla, Juan Alfredo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2005
Last updated Mar 7th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548260078 NPPES
Other F0072234 DPS
Other G4841 DPS
MEDICAID 095065103 DPS
MEDICAID 120180801 DPS
MEDICAID 120180805 DPS

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