Individual
DR. MEGAN E BOUCHAREB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12554 RIATA VISTA CIR, AUSTIN, TX 78727-6431
(512) 795-5100
(512) 795-5122
Mailing address
12554 RIATA VISTA CIR, AUSTIN, TX 78727-6431
(512) 795-5100
(512) 795-5122
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
002738
GA
2085R0202X
Diagnostic Radiology Physician
Primary
44255
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
615203
—
AZ
Enumeration date
02/06/2008
Last updated
11/09/2016
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