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General NPI Number Information
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NPI Number | 1194269217
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Entity Type | Individual
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Provider Name | JESSICA BOICE
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Gender | Female
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Dates
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Enumeration Date | 12/08/2016
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Last Update Date | 09/27/2023
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Provider Practice Location Address
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Address Line | 3705 MEDICAL PKWY STE 410
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City | AUSTIN
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State | TX
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Zip | 78705-1023
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Country | US
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Telephone | 512-320-5779
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Fax |
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Provider Business Mailing Address
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Address Line | 6810 DEATONHILL DR APT 2201
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City | AUSTIN
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State | TX
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Zip | 78745-4734
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Country | US
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Telephone | 832-752-9746
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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