LARRY EDWARD BOLTON

AUSTIN, TX
NPI1164684692
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: TX  PA 02475)
Additional Taxonomies363AS0400X Physician Assistant, Surgical
(Licence: TX  PA 02475)
Enumeration Date2008-06-26
Last Update Date2008-06-26
Business Address
-- LARRY EDWARD BOLTON PA-C
3000 S IH 35 STE 205
AUSTIN, TX 78704-6513
Phone number: 512-912-8200
Mailing Address
-- LARRY EDWARD BOLTON PA-C
3000 S IH 35 STE 205
AUSTIN, TX 78704-6513
Phone number: 512-912-8200