Individual
DR. BUNDHIT TANTIWONGKOSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7400 MERTON MINTER ST, SAN ANTONIO, TX 78229-4404
(210) 617-5300
Mailing address
7400 MERTON MINTER ST, SAN ANTONIO, TX 78229-4404
(210) 617-5300
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A103495
CA
390200000X
Student in an Organized Health Care Education/Training Program
57-009559
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0A1034950
—
CA
Enumeration date
05/11/2007
Last updated
07/24/2009
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