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Individual
FELICIA BOUTTE
Active
Individual
FELICIA BOUTTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA04367
TX
363AM0700X
Medical Physician Assistant
PA04364
TX
363AM0700X
Medical Physician Assistant
PA04367
TX
Other
Enumeration date
10/14/2010
Last updated
12/14/2022
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