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NPI Code Detail

MEDICARE: DR. DEBORAH N BOUDREAUX DDS

MEDICARE: DR. DEBORAH N BOUDREAUX DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry17134TX

General Provider Information

NPI Number : 1669480307
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEBORAH N BOUDREAUX DDS
Provider Business Mailing Address
First Line : 3121 BUFFALO SPEEDWAY
Second Line : #3107
City : HOUSTON
State : TX
Zip : 77098-1971
Country : US
Telephone Number : 713-927-2009
Fax Number :
Provider Business Practice Location Address
First Line : 3121 BUFFALO SPEEDWAY
Second Line : #3107
City : HOUSTON
State : TX
Zip : 76901
Country : US
Telephone Number : 713-927-2009
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2006
Last Update Date : 09/02/2011

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