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General NPI Number Information
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NPI Number | 1689868648
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Entity Type | Organization
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Legal Business Name | BOERNE WOMEN'S CARE, PLLC
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Dates
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Enumeration Date | 09/04/2007
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Last Update Date | 07/31/2008
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Provider Practice Location Address
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Address Line | 124 E BANDERA RD SUITE 204
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City | BOERNE
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State | TX
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Zip | 78006-2849
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Country | US
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Telephone | 830-331-9674
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Fax | 830-331-9675
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Provider Business Mailing Address
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Address Line | 124 E BANDERA RD SUITE 204
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City | BOERNE
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State | TX
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Zip | 78006-2849
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Country | US
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Telephone | 830-331-9674
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Fax | 830-331-9675
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL JAMES SMITH
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Credential | M.D.
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Telephone | 830-331-9674
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | L2776
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License Number State | TX
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