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General NPI Number Information
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NPI Number | 1699779330
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Entity Type | Individual
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Provider Name | JAMES LEE BOYSEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/10/2005
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Last Update Date | 07/12/2012
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Provider Practice Location Address
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Address Line | 1106 WEST. DITTMAR TEXAS NEURO REHAB CENTER
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City | AUSTIN
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State | TX
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Zip | 78745
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Country | US
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Telephone | 512-442-5326
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Fax | 512-462-6709
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Provider Business Mailing Address
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Address Line | 8708 MENDOCINO DRIVE
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City | AUSTIN
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State | TX
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Zip | 78735
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Country | US
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Telephone | 512-422-5326
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Fax | 512-462-6709
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | G6456
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G-6456
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | G-6456
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | G-6456
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License Number State | TX
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