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General NPI Number Information
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NPI Number | 1649446568
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Entity Type | Organization
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Legal Business Name | DON R BOSSE MD PA
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Dates
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Enumeration Date | 04/30/2008
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Last Update Date | 04/30/2008
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Provider Practice Location Address
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Address Line | 235 W PALM ST SUITE 105
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City | BELLVILLE
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State | TX
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Zip | 77418-1372
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Country | US
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Telephone | 979-865-3124
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Fax | 979-865-9193
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Provider Business Mailing Address
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Address Line | 235 W PALM ST SUITE 105
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City | BELLVILLE
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State | TX
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Zip | 77418-1372
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Country | US
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Telephone | 979-865-3124
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Fax | 979-865-9193
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DON R BOSSE
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Credential | M.D.
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Telephone | 979-865-3124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G3169
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License Number State | TX
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