Individual
MICHAEL BOURGEOIS
Active
Individual
MICHAEL BOURGEOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
F5842
TX
208M00000X
Hospitalist Physician
F5842
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100086010B
—
OK
01
—
108958105
FIRSTCARE COMMERCIAL
TX
05
—
138369704
—
TX
05
—
138369711
—
TX
01
—
36233
PRESBYTERIAN COMMERCIAL
NM
05
—
36233
—
NM
01
—
460001727
RAILROAD
TX
01
—
80822Z
HMO BLUE
TX
01
—
89C152
BC/BS
TX
01
—
A119
TRIWEST
NM
05
—
V2944
—
NM
Enumeration date
11/03/2005
Last updated
12/03/2021
Update your record
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