Individual
DANIEL ALEXANDER BOUDREAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.09/29/1935
Contact information
Practice address
5833 SPOHN DR STE 401, CORPUS CHRISTI, TX 78414-4136
(361) 992-9432
Mailing address
5833 SPOHN DR STE 401, CORPUS CHRISTI, TX 78414-4136
(361) 992-9432
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
D-5354
TX
208VP0000X
Pain Medicine Physician
Primary
D-5354
TX
Other
Enumeration date
09/22/2006
Last updated
02/29/2008
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