Individual
JUAN ALFREDO BONILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16723 HUEBNER RD, SAN ANTONIO, TX 78248-2351
(210) 644-3600
(210) 702-6963
Mailing address
16723 HUEBNER RD, SAN ANTONIO, TX 78248-2351
(210) 644-3600
(210) 702-6963
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
G4841
TX
207YP0228X
Pediatric Otolaryngology Physician
Primary
G4841
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
095065103
—
TX
05
—
120180801
—
TX
05
—
120180805
—
TX
01
—
F0072234
DPS
—
01
—
G4841
STATE LIC
TX
Enumeration date
07/27/2005
Last updated
04/09/2026
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