Individual
JONATHAN BONILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1255 ASHBY ST STE A, SEGUIN, TX 78155-5100
(830) 590-8049
Mailing address
5224 75TH ST STE D, LUBBOCK, TX 79424-2525
(806) 712-1096
(806) 771-2093
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
MD.204149
LA
207RI0011X
Interventional Cardiology Physician
Primary
U5573
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03208741
—
MS
05
—
1105023
—
LA
Enumeration date
06/12/2008
Last updated
03/12/2025
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