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General NPI Number Information
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NPI Number | 1346865037
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Entity Type | Individual
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Provider Name | MICHAEL THOMAS BOONE DO
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Gender | Male
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Dates
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Enumeration Date | 06/09/2020
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 3828 S 1ST ST
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City | AUSTIN
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State | TX
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Zip | 78704-7048
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Country | US
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Telephone | 512-443-1311
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Fax |
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Provider Business Mailing Address
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Address Line | 6210 E HWY 290
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City | AUSTIN
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State | TX
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Zip | 78723-1142
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Country | US
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Telephone | 512-483-9596
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Fax | 512-406-6216
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | T3440
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | BP10070627
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License Number State | TX
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