MEDICARE: AUSTIN JOHN BOLANO DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	40386	TX

General Provider Information

NPI Number	:	1053000281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUSTIN JOHN BOLANO DMD

Provider Business Mailing Address
First Line	:	7 GILDED POND PL
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77381-6456
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 GILDED POND PL
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77381-6456
Country	:	US
Telephone Number	:	281-536-3120
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2023
Last Update Date	:	11/25/2025

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Directions to “ AUSTIN JOHN BOLANO DMD” Practice Location

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