Individual provider · NPI-1

Rogelio Bill Fontanilla, CRNA

Nurse Anesthetist, Certified Registered · Galveston, TX

NPI number1104966506
StatusActive
Last updated in NPPESJun 9, 2009

Details

NPI
1104966506
Entity type
Individual (NPI-1)
Name
Rogelio Bill Fontanilla
Credential
CRNA
Sex
Male
Sole proprietor
No
Enumeration date
Feb 7, 2007
Last updated
Jun 9, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
367500000X Nurse Anesthetist, Certified Registered610236TXYes

Practice location

301 University Blvd
Galveston, TX 77555-5302

Phone 409-772-2222

Mailing address

301 University Blvd
Galveston, TX 77555-5302

Phone 409-772-2222

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