Individual
DR. JOHN REYNOLDS BOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16651 SOUTHWEST FWY, MOB 1 SUITE 310, SUGAR LAND, TX 77479-2345
(281) 565-1250
Mailing address
16651 SOUTHWEST FWY, MOB 1 SUITE 310, SUGAR LAND, TX 77479-2345
(281) 565-1250
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
N2957
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1813154384
BLUE CROSS BLUE SHIELD
TX
05
—
280592101
—
TX
05
—
280592102
—
TX
01
—
P00748658
RAILROAD MEDICARE
TX
01
—
P01062995
RAILROAD MEDICARE
TX
Enumeration date
01/08/2009
Last updated
02/12/2014
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