Individual
PAUL V BONARRIGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPT, PC
Contact information
Practice address
2011 E VILLA MARIA RD # A, BRYAN, TX 77802-2541
(979) 776-2225
(979) 776-7945
Mailing address
2011 E VILLA MARIA RD # A, BRYAN, TX 77802-2541
(979) 776-2225
(979) 776-7945
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1005635
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8AJ910
BLUE CROSS
—
Enumeration date
11/28/2006
Last updated
04/14/2008
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