MEDICARE: DR. MICHAEL M BOUYARDEN MD

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	282N00000X	General Acute Care Hospital
2	207RN0300X	Nephrology Physician	N4956	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477712024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL M BOUYARDEN MD

Provider Business Mailing Address
First Line	:	5410 BELLAIRE BLVD STE 203
Second Line	:
City	:	BELLAIRE
State	:	TX
Zip	:	77401-3964
Country	:	US
Telephone Number	:	504-444-7664
Fax Number	:

Provider Business Practice Location Address
First Line	:	5410 BELLAIRE BLVD STE 203
Second Line	:
City	:	BELLAIRE
State	:	TX
Zip	:	77401-3964
Country	:	US
Telephone Number	:	504-444-7664
Fax Number	:

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

Provider Enumeration Date	:	06/07/2008
Last Update Date	:	01/23/2026

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Directions to “ DR. MICHAEL M BOUYARDEN MD” Practice Location

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