Individual
DR. BOULOS TOURSARKISSIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9153 HUEBNER RD., SAN ANTONIO, TX 78240-1502
(210) 614-7414
(210) 616-0509
Mailing address
610 NORTH MAIN, SECOND FLOOR, SAN ANTONIO, TX 78205-1204
(210) 828-2503
(210) 828-5731
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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