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General NPI Number Information
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NPI Number | 1457522468
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Entity Type | Organization
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Legal Business Name | H. JAY BOULAS, M.D., P.A.
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Dates
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Enumeration Date | 03/18/2008
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Last Update Date | 03/18/2008
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Provider Practice Location Address
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Address Line | 8220 WALNUT HILL LN SUITE 514
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City | DALLAS
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State | TX
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Zip | 75231-4427
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Country | US
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Telephone | 214-345-4595
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Fax | 214-345-4596
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Provider Business Mailing Address
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Address Line | 8220 WALNUT HILL LN SUITE 514
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City | DALLAS
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State | TX
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Zip | 75231-4427
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Country | US
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Telephone | 214-345-4595
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Fax | 214-345-4596
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. H. JAY BOULAS
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Credential | M.D.
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Telephone | 214-345-4595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G8014
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License Number State | TX
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