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Individual
DR. SUSAN L BOULLIOUN
Active
Individual
DR. SUSAN L BOULLIOUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K2312
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121420704
—
TX
05
—
121420705
—
TX
05
—
205495901
—
TX
Enumeration date
10/17/2006
Last updated
06/10/2026
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