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General NPI Number Information
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NPI Number | 1962761437
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Entity Type | Individual
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Provider Name | CANEITA QUIARA BOSLEY MD
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Gender | Female
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Dates
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Enumeration Date | 05/03/2012
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Last Update Date | 06/15/2022
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Provider Practice Location Address
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Address Line | 2727 W HOLCOMBE BLVD
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City | HOUSTON
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State | TX
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Zip | 77025-1669
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Country | US
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Telephone | 713-442-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 3208 N MACGREGOR WAY UNIT C
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City | HOUSTON
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State | TX
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Zip | 77004-8151
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Country | US
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Telephone | 810-869-3522
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Fax |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 430111404
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | Q4074
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License Number State | TX
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