Healthcare Provider Details

I. General information

NPI: 1861870933
Provider Name (Legal Business Name): DANIEL PAUL BOLTON M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2015
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 PEASE ST STE 600
HARLINGEN TX
78550-8326
US

IV. Provider business mailing address

PO BOX 5730
BELFAST ME
04915-5700
US

V. Phone/Fax

Practice location:
  • Phone: 956-215-8520
  • Fax:
Mailing address:
  • Phone:
  • Fax: 956-440-9801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberU0078
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberU0078
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License NumberU0078
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: