Individual
NATHALIE BOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
301 LONDONDERRY DR, WACO, TX 76712-7915
(254) 751-4880
(254) 751-4885
Mailing address
301 LONDONDERRY DR, WACO, TX 76712-7915
(254) 751-4880
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
2019024539
MO
2084P0800X
Psychiatry Physician
Primary
S9270
TX
Other
Enumeration date
08/10/2016
Last updated
05/12/2023
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