Individual provider · Type 1 NPI

Issac Isaiah Bolanos, PA

Medical Physician Assistant · Austin, TX

NPI number 1407193840 Active

Practice location

1313 Red River St, Suite 200
Austin, TX 78701-1943

Fax (512) 391-1906

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA08063 (TX)

Medical Physician Assistant: Definition to come...

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About NPI 1407193840

Issac Isaiah Bolanos, PA's National Provider Identifier is 1407193840, issued on Jan 4, 2013. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Austin, TX. The record was last updated on Jan 4, 2013.