Organization
H. JAY BOULAS, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. H. JAY BOULAS M.D. (PRESIDENT)
(214) 345-4595
Entity
Organization
Contact information
Practice address
8220 WALNUT HILL LN, SUITE 514, DALLAS, TX 75231-4427
(214) 345-4595
(214) 345-4596
Mailing address
8220 WALNUT HILL LN, SUITE 514, DALLAS, TX 75231-4427
(214) 345-4595
(214) 345-4596
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G8014
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0022AM
BLUE CROSS BLUE SHIELD TX
TX
Enumeration date
03/18/2008
Last updated
03/18/2008
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