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General NPI Number Information
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NPI Number | 1043841919
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Entity Type | Individual
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Provider Name | JOHN ANTHONY BOJANSKI PA-C
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Gender | Male
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Dates
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Enumeration Date | 01/30/2020
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Last Update Date | 01/02/2024
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Provider Practice Location Address
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Address Line | 10410 MEDICAL LOOP BLDG 6B
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City | LAREDO
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State | TX
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Zip | 78045-6906
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Country | US
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Telephone | 956-728-8121
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Fax |
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Provider Business Mailing Address
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Address Line | 1006 E HILLSIDE RD # 1
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City | LAREDO
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State | TX
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Zip | 78041-3287
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Country | US
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Telephone | 956-724-7179
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA13362
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License Number State | TX
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