ISSAC ISAIAH BOLANOS PA NPI 1407193840

NPI Information

  • NPI: 1407193840
  • Provider Name: ISSAC ISAIAH BOLANOS, PA
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • Address: 1313 RED RIVER ST
    SUITE 200
    AUSTIN, TX
    ZIP 78701
  • Phone: (512) 391-1751

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NPI Details

Issac Isaiah Bolanos, PA is a medical physician assistant in Austin, TX. Issac Isaiah Bolanos, PA NPI is 1407193840. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1313 RED RIVER ST
SUITE 200
AUSTIN, TX
ZIP 78701-943
Phone: (512) 391-1751
Fax: (512) 391-1906

The enumeration date for this NPI number is 1/4/2013 and was last updated on 1/4/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedicalPA08063TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1PA08063OTHERTEXASTX LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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