Individual
MR. BONIFACE MBAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12634 NACOGDOCHES RD, SAN ANTONIO, TX 78217-2118
(713) 505-6686
Mailing address
12634 NACOGDOCHES RD, SAN ANTONIO, TX 78217-2118
(713) 505-6686
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
023742
TX
374U00000X
Home Health Aide
023742
TX
Other
Enumeration date
01/06/2025
Last updated
01/06/2025
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