MEDICARE: JAMIE LEE BOUBEL LVN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164X00000X	Licensed Vocational Nurse	349986	TX

General Provider Information

NPI Number	:	1144164914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE LEE BOUBEL LVN

Provider Business Mailing Address
First Line	:	5016 E FM 1518 N
Second Line	:
City	:	SELMA
State	:	TX
Zip	:	78154-1360
Country	:	US
Telephone Number	:	210-654-9300
Fax Number	:	210-855-0878

Provider Business Practice Location Address
First Line	:	5016 E FM 1518 N
Second Line	:
City	:	SELMA
State	:	TX
Zip	:	78154-1360
Country	:	US
Telephone Number	:	210-654-9300
Fax Number	:	210-855-0878

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2026
Last Update Date	:	04/14/2026

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Directions to “ JAMIE LEE BOUBEL LVN” Practice Location

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