MEDICARE: HOWARD BOLAND M.D.

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	2084P0800X	Psychiatry Physician	G3166	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00B25C	OTHER		BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811186844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOWARD BOLAND M.D.

Provider Business Mailing Address
First Line	:	914 FM 517 W, 201B
Second Line	:
City	:	DICKINSON
State	:	TX
Zip	:	77539-3923
Country	:	US
Telephone Number	:	281-337-1350
Fax Number	:	281-337-1350

Provider Business Practice Location Address
First Line	:	914 FM 517 W, 201B
Second Line	:
City	:	DICKINSON
State	:	TX
Zip	:	77539-3923
Country	:	US
Telephone Number	:	281-337-1350
Fax Number	:	281-337-1350

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

Provider Enumeration Date	:	10/16/2007
Last Update Date	:	02/26/2009

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Directions to “ HOWARD BOLAND M.D.” Practice Location

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