Individual
MR. HENRY ENRIQUE BOLANOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
212 STAUNTON DR, LEANDER, TX 78641-5469
(512) 644-1931
(214) 764-0880
Mailing address
214 RILEY LN, FREDERICKSBURG, TX 78624-3562
(214) 227-2457
(214) 764-0880
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
196515
TX
246ZC0007X
Surgical Assistant
Primary
SA00938
TX
363AS0400X
Surgical Physician Assistant
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Other
Enumeration date
02/15/2022
Last updated
09/24/2023
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