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Individual
NEDRANA BOUTTE
Active
Individual
NEDRANA BOUTTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M6974
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
189110301
—
TX
01
—
8S2464
BCBS
TX
Enumeration date
05/30/2007
Last updated
01/05/2010
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