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1124038336
VICENTE BAUTISTA
EDINBURG, TX
NPI
1124038336
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: TX PA 04805)
Enumeration Date
2006-08-09
Last Update Date
2019-07-15
Business Address
VICENTE BAUTISTA PA
1102 W TRENTON RD
EDINBURG, TX 78539-9105
Phone number: 956-388-6000
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Mailing Address
VICENTE BAUTISTA PA
200 CORPORATE BLVD
LAFAYETTE, LA 70508-3870
Phone number: 800-893-9698
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