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Individual
MATTHEW HOWARD BOUTTE
Active
Individual
MATTHEW HOWARD BOUTTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C, MPAS
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA09060
TX
390200000X
Student in an Organized Health Care Education/Training Program
MA053903
PA
Other
Enumeration date
06/26/2009
Last updated
06/04/2015
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