Individual
DR. CARL DAVID BOETHEL
Active
Individual
DR. CARL DAVID BOETHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
L9629
TX
207RS0012X
Sleep Medicine (Internal Medicine) Physician
L9629
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1683856-01
CSHCN
TX
05
—
1683856-01
—
TX
01
—
8P9110
BLUE SHIELD
TX
01
—
P00184712
RR/MEDICARE
TX
Enumeration date
03/21/2006
Last updated
12/03/2021
Update your record
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