# DR. JOHN REYNOLDS BOON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1013154384
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | N2957 | TX | Yes |

## Other

- **Enumeration date:** 01/08/2009
- **Last updated:** 02/12/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1813154384 | BLUE CROSS BLUE SHIELD | TX |
| 05 | — | 280592101 | — | TX |
| 05 | — | 280592102 | — | TX |
| 01 | — | P00748658 | RAILROAD MEDICARE | TX |
| 01 | — | P01062995 | RAILROAD MEDICARE | TX |