Individual
DR. BOULOS TOURSARKISSIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
K4591
TX
2086S0129X
Vascular Surgery Physician
Primary
K4591
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117146402
CIDC
TX
05
—
117146403
—
TX
05
—
117146408
—
TX
01
—
770001947
MEDICARE RAIL ROAD
TX
01
—
80010S
BLUE CROSS BLUE SHIELD
TX
01
—
81549J
MEDICARE PIN FOR GROUP 00T148
TX
01
—
8FA758
BCBSTX - PVA
TX
01
—
P01465883
MEDICARE RR - PVA
TX
Enumeration date
08/01/2006
Last updated
07/21/2023
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