Larry Edward Bolton in Austin - Physician Assistant
Larry Edward Bolton - NPI 1164684692
Larry Edward Bolton is a Physician Assistant in Austin, Texas. Larry Edward Bolton practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Larry Edward Bolton is 1164684692. The last update date is 2008-06-26.
Larry Edward Bolton's current location address is 3000 S Ih 35, Austin, Texas. You can contact this provider via phone number 5129128200 and fax number 5129128206. The mailing address for Larry Edward Bolton is 3000 S Ih 35, Austin, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Larry Edward Bolton |
|---|---|
| Address | 3000 S Ih 35, Austin, Texas |
| Phone Number | 5129128200 |
| Fax Number | 5129128206 |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1164684692 |
|---|---|
| Provider Enumeration Date | 2008-06-26 |
| Last Updated Date | 2008-06-26 |
Provider Mailing Address Detail
| Address | 3000 S Ih 35 |
|---|---|
| City | Austin |
| State | Texas (TX) |
| Post Code | 787046513 |
| Phone Number | 5129128200 |
| Fax Number | 5129128206 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA 02475 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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What is the unique 10-digit identification code assigned to Larry Edward Bolton by the Centers for Medicare & Medicaid Services?
The Larry Edward Bolton has been issued the NPI (National Provider Identifier) 1164684692, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Larry Edward Bolton's physical address?
The Larry Edward Bolton is physically located at 3000 S Ih 35, in the city of Austin, TX, with the postal code 787046513.
What is the area of specialization for Larry Edward Bolton, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Larry Edward Bolton is Physician Assistant, and the corresponding taxonomy code that categorizes this area of expertise is 363A00000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1164684692 to Larry Edward Bolton?
The Centers for Medicare & Medicaid Services originally issued the 1164684692 to Larry Edward Bolton on 2008-06-26.
When was the Larry Edward Bolton's information last updated?
The Larry Edward Bolton's information was last updated on 2008-06-26.