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General NPI Number Information
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NPI Number | 1366688749
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Entity Type | Organization
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Legal Business Name | BOURLAND SOBEN PLLC
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Dates
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Enumeration Date | 01/06/2009
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Last Update Date | 01/06/2009
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Provider Practice Location Address
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Address Line | 4601 BUFFALO GAP RD SUITE D-1
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City | ABILENE
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State | TX
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Zip | 79606-3375
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Country | US
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Telephone | 325-695-3300
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Fax | 325-695-9899
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Provider Business Mailing Address
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Address Line | 4601 BUFFALO GAP RD SUITE D-1
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City | ABILENE
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State | TX
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Zip | 79606-3375
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Country | US
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Telephone | 325-695-3300
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Fax | 325-695-9899
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Authorized Official
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Title or Position | DENTIST
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Name | DR. BART BOURLAND
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Credential | DDS
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Telephone | 325-695-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 18681
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License Number State | TX
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