Individual
BONIFACE GBALAZEH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
114 SANDSTONE CT, VICTORIA, TX 77904-2952
(361) 212-4806
(361) 212-7683
Mailing address
114 SANDSTONE CT, VICTORIA, TX 77904-2952
(361) 212-4806
(361) 212-7683
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
E8260
TX
207Q00000X
Family Medicine Physician
E8260
TX
Other
Enumeration date
03/05/2007
Last updated
02/12/2014
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