Individual
PAUL DAVID BERTOLINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8401 DATAPOINT DR STE 600, SAN ANTONIO, TX 78229-5907
(210) 616-7700
(210) 616-7709
Mailing address
PO BOX 29441, SAN ANTONIO, TX 78229-0441
(210) 616-7700
(210) 616-7709
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
N9811
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2834038-03
—
TX
05
—
2834038-04
—
TX
05
—
2834038-05
—
TX
01
—
N9811
TEXAS LICENSE
TX
01
—
P01473755
RAILROAD MEDICARE
TX
01
—
P01473765
RAILROAD MEDICARE
TX
Enumeration date
06/07/2011
Last updated
03/14/2016
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