# DR. BOULOS TOURSARKISSIAN

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

## Provider details

- **NPI number:** 1073529665
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | K4591 | TX | — |
| 2086S0129X | Vascular Surgery Physician | K4591 | TX | Yes |

## Other

- **Enumeration date:** 08/01/2006
- **Last updated:** 07/21/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 117146402 | CIDC | TX |
| 05 | — | 117146403 | — | TX |
| 05 | — | 117146408 | — | TX |
| 01 | — | 770001947 | MEDICARE RAIL ROAD | TX |
| 01 | — | 80010S | BLUE CROSS BLUE SHIELD | TX |
| 01 | — | 81549J | MEDICARE PIN FOR GROUP 00T148 | TX |
| 01 | — | 8FA758 | BCBSTX - PVA | TX |
| 01 | — | P01465883 | MEDICARE RR - PVA | TX |