Provider Demographics
NPI:1528493459
Name:DEL BOSQUE, RENE III (PA)
Entity type:Individual
Prefix:MR
First Name:RENE
Middle Name:
Last Name:DEL BOSQUE
Suffix:III
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 E NOLANA AVE STE A
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-6190
Mailing Address - Country:US
Mailing Address - Phone:956-618-0348
Mailing Address - Fax:956-618-0382
Practice Address - Street 1:1309 E NOLANA AVE STE A
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-6190
Practice Address - Country:US
Practice Address - Phone:956-618-0348
Practice Address - Fax:956-618-0382
Is Sole Proprietor?:No
Enumeration Date:2013-09-10
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
TXPA08324363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX340157201Medicaid
TX358731YLPSOtherWELLMED PTAN