Individual
BORIS BRATOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
6560 FANNIN ST, SUITE 1842, HOUSTON, TX 77030-2761
(713) 790-5227
(713) 790-5505
Mailing address
PO BOX 3567, HOUSTON, TX 77253-3567
(713) 790-5227
(713) 790-5505
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA00358
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201956401
—
TX
01
—
86N033
BCBS
TX
Enumeration date
07/26/2005
Last updated
03/11/2024
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