Provider Demographics
NPI:1780632042
Name:GONZALEZ, ALEJANDRO BONILLA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEJANDRO
Middle Name:BONILLA
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5414 FREDERICKSBURG RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3641
Mailing Address - Country:US
Mailing Address - Phone:210-541-8281
Mailing Address - Fax:210-541-9123
Practice Address - Street 1:5414 FREDERICKSBURG RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3641
Practice Address - Country:US
Practice Address - Phone:210-541-8281
Practice Address - Fax:210-541-9123
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXF15912080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE20511Medicare UPIN