Individual
ULISES BONILLA BURGOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
208 STARR ST, SUITE 3, MERCEDES, TX 78570-2734
(956) 903-4218
(956) 903-4149
Mailing address
208 STARR ST, SUITE 3, MERCEDES, TX 78570-2734
(956) 903-4218
(956) 903-4149
Taxonomy
Speciality
Code
Description
License number
State
193200000X
Multi-Specialty Group
Primary
Q9961
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q9961
MEDICAL LICENSE TEXAS
TX
Enumeration date
08/26/2013
Last updated
01/31/2017
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